# BEACON HEALTH SYSTEMS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598024440
- **Authorized official:** MR. PRINCE EJEMOLE (ADMINISTRATOR)
- **Authorized official phone:** (478) 457-7706

## Contact information

- **Practice address:** 507 N HOUSTON RD, SUITE D-3, WARNER ROBINS, GA 31093-8828
- **Practice address phone:** (478) 845-0881
- **Practice address fax:** (478) 845-0858
- **Mailing address:** 3898 CRAGGY PERCH, DOUGLASVILLE, GA 30135-8700
- **Mailing address phone:** (478) 845-0881
- **Mailing address fax:** (478) 845-0858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 005-R-1041 | GA | Yes |

## Other

- **Enumeration date:** 05/14/2012
- **Last updated:** 07/17/2013