Organization
141 BEACON OPERATOR LLC
Active
Other names
Our Home at Beacon Hill
Organization subpart
No
Provider details
NPI number
Authorized official
LUAN MORROW (EXECUTIVE DIRECTOR)
(941) 320-4210
Entity
Organization
Contact information
Practice address
141 KAELYN LN, PORT ST JOE, FL 32456-6180
(850) 647-4000
Mailing address
141 KAELYN LN, PORT ST JOE, FL 32456-6180
(850) 647-4000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104726900
—
FL
Enumeration date
07/16/2019
Last updated
02/04/2020
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