Organization
BEACON HEALTH VENTURES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PETER COSTELLO (CFO)
(574) 647-3460
Entity
Organization
Contact information
Practice address
807 E COLFAX AVE, SOUTH BEND, IN 46617-2803
(574) 855-1420
Mailing address
807 E COLFAX AVE, SOUTH BEND, IN 46617-2803
(574) 855-1420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
01/28/2026
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