Organization
BEACON HEALTH VENTURES MICHIGAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L SMIGIELSKI (MANAGER)
(574) 647-8731
Entity
Organization
Contact information
Practice address
69045 M-62, SUITE A-1, EDWARDSBURG, MI 49112
(269) 663-2201
(269) 663-2209
Mailing address
3355 DOUGLAS ROAD, SOUTH BEND, IN 46635
(574) 647-8731
(574) 647-8768
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578619078
—
MI
Enumeration date
01/26/2007
Last updated
02/16/2018
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