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Organization
BEACON SPECIALIZED LIVING SERVICES, INC.
Active
Organization
BEACON SPECIALIZED LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN RATZLAFF (PRESIDENT, CEO)
(269) 427-8400
Entity
Organization
Contact information
Practice address
555 RAILROAD ST, BANGOR, MI 49013-1464
(269) 427-8400
(269) 427-6027
Mailing address
555 RAILROAD ST, P.O. BOX 69, BANGOR, MI 49013-1464
(269) 427-8400
(269) 427-6027
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
251E00000X
Home Health Agency
—
NULL
310400000X
Assisted Living Facility
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
01/10/2007
Last updated
03/31/2015
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