Organization
BEACON OUTREACH INITIATIVES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOBINA S SACKEY (OPERATIONS MANAGER)
(714) 864-0735
Entity
Organization
Contact information
Practice address
619 E 116TH PL, LOS ANGELES, CA 90059-2311
(714) 864-0735
Mailing address
1717 WEST 85TH STREET, LA, CA 90048
(323) 472-7784
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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