Organization
BEACON HEALTH VENTURES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L SMIGIELSKI (MANAGER)
(574) 647-8731
Entity
Organization
Contact information
Practice address
3355 DOUGLAS ROAD, SOUTH BEND, IN 46635-1780
(574) 647-2273
Mailing address
3355 DOUGLAS ROAD, SOUTH BEND, IN 46635-1780
(574) 647-8731
(574) 647-8768
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
06-005298-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000098082
ANTHEM - HHA
IN
05
—
100091080A
—
IN
Enumeration date
06/22/2006
Last updated
02/16/2018
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