Organization
BEACON OF LIGHT SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA KEY (CHIEF EXECUTIVE OFFICER)
(980) 248-7854
Entity
Organization
Contact information
Practice address
1708 S MAIN ST, SALISBURY, NC 28144-6710
(980) 248-7854
Mailing address
1708 S MAIN ST, SALISBURY, NC 28144-6710
(980) 248-7854
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
08/26/2024
Last updated
02/03/2026
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