Organization
BEACON HEALTH VENTURES, INC.
Active
Other names
Compassionate Caregivers - ELK
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY M CONRAD (PRESIDENT)
(574) 647-8777
Entity
Organization
Contact information
Practice address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1781
(574) 273-2273
Mailing address
5155 VERDANT ST, ELKHART, IN 46516-9315
(574) 295-1111
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
14-012264-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100263690D
IHCP WAIVER
IN
Enumeration date
03/28/2014
Last updated
02/27/2017
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