Organization
BEACON SPECIALIZED LIVING OHIO INC
Active
Parent organization
KEYSTONE COMMUNITY RESOURCES
Other names
Beacon Specialized Living, Beacon Services Holdings, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEYSTONE COMMUNITY RESOURCES
Authorized official
JANET PELL (VP OF OPS AND BUSINESS DEVELOPMENT)
(614) 330-3073
Entity
Organization
Contact information
Practice address
1460 GRACELAND DR, FAIRBORN, OH 45324-4374
(937) 874-5001
Mailing address
967 WORTHINGTON WOODS LOOP RD, WORTHINGTON, OH 43085-5743
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2916025
OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES
OH
Enumeration date
03/01/2023
Last updated
03/01/2023
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