Organization
BEACON HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W SPENCER KLINE III JD MED LPC (CEO)
(440) 354-9924
Entity
Organization
Contact information
Practice address
9220 MENTOR AVENUE, MENTOR, OH 44060-6412
(440) 354-9924
(440) 205-1009
Mailing address
9220 MENTOR AVENUE, MENTOR, OH 44060-6412
(440) 354-9924
(440) 205-1009
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2362429
—
OH
Enumeration date
04/28/2006
Last updated
10/30/2014
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