Organization
BEACON HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN J POPP (CFO)
(440) 639-3509
Entity
Organization
Contact information
Practice address
9220 MENTOR AVE, MENTOR, OH 44060-6412
(440) 354-9924
(440) 205-1009
Mailing address
9220 MENTOR AVENUE, MENTOR, OH 44060
(440) 354-9924
(440) 205-1009
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2890000
—
OH
Enumeration date
06/15/2012
Last updated
11/07/2016
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