# BEACON OUTREACH INITIATIVES LLC

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

## Provider details

- **NPI number:** 1699594812
- **Authorized official:** KOBINA S SACKEY (OPERATIONS MANAGER)
- **Authorized official phone:** (714) 864-0735

## Contact information

- **Practice address:** 619 E 116TH PL, LOS ANGELES, CA 90059-2311
- **Practice address phone:** (714) 864-0735
- **Mailing address:** 1717 WEST 85TH STREET, LA, CA 90048
- **Mailing address phone:** (323) 472-7784

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 10/04/2024
- **Last updated:** 10/04/2024