Beacon Specialized Living Ohio INC

NPI #1265131064 in Fairborn, Ohio

Provider Information

NPI Number: 1265131064
Entity Type: Organization
Organization Name: Beacon Specialized Living Ohio INC
Subpart: Yes (part of a larger organization)
Parent Organization: KEYSTONE COMMUNITY RESOURCES
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 1, 2023
Last Updated: Mar 1, 2023

Practice Location

Address: 1460 GRACELAND DR
City: Fairborn
State: Ohio
ZIP Code: 45324-4374
Phone: (937) 874-5001

Authorized Official

Name: JANET PELL
Title: VP OF OPS AND BUSINESS DEVELOPMENT
Phone: (614) 330-3073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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