Organization
BEACON SPECIALIZED LIVING SERVICES INC
Active
Parent organization
BEACON SPECIALIZED LIVING SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEACON SPECIALIZED LIVING SERVICES INC
Authorized official
NATHAN RATZLAFF (OWNER)
(269) 427-8400
Entity
Organization
Contact information
Practice address
555 RAILROAD ST, BANGOR, MI 49013-1464
(269) 427-8400
Mailing address
555 RAILROAD ST, PO BOX 69, BANGOR, MI 49013-1464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
04/22/2015
Last updated
01/27/2016
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