Organization
BEACON POINTE
Active
Parent organization
DOCKERTY HEALTH CARE SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOCKERTY HEALTH CARE SERVICES
Authorized official
TODD DOCKERTY (OWNER/COO)
(269) 775-1430
Entity
Organization
Contact information
Practice address
732 E CENTRE AVE, PORTAGE, MI 49002-5517
(269) 775-1430
Mailing address
111 W FERRY ST, BERRIEN SPRINGS, MI 49103-1154
(269) 465-7600
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL390381477
ADULT FOSTER CARE
MI
Enumeration date
05/02/2019
Last updated
06/11/2019
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