Organization
OUR HOME AT BEACON HILL BSLC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZA ROJAS (MANAGER)
(941) 809-6147
Entity
Organization
Contact information
Practice address
141 KAELYN LN, PORT ST JOE, FL 32456-6180
(850) 647-4000
(850) 647-4004
Mailing address
141 KAELYN LN, PORT ST JOE, FL 32456-6180
(850) 647-4000
(850) 647-4004
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004659700
—
FL
Enumeration date
04/17/2015
Last updated
04/17/2015
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