Organization
BEACON HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY ANN HIBBARD RN (EXECUTIVE PARTNER)
(810) 966-3480
Entity
Organization
Contact information
Practice address
415 QUAY ST, PORT HURON, MI 48060-3829
(810) 966-3480
(810) 966-3483
Mailing address
415 QUAY ST, PORT HURON, MI 48060-3829
(810) 966-3480
(810) 966-3483
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4088483
—
MI
Enumeration date
05/05/2006
Last updated
08/22/2020
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