| Beacon Specialized Living Services, Inc. | |
|
555 Railroad St Bangor MI 49013-1464 | |
| (269) 427-8400 | |
| (269) 427-6027 |
| Full Name | Beacon Specialized Living Services, Inc. |
|---|---|
| Speciality | Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Location | 555 Railroad St, Bangor, Michigan |
| Authorized Official Name and Position | Ken Ratzlaff (PRESIDENT, CEO) |
| Authorized Official Contact | 2694278400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Specialized Living Services, Inc. 555 Railroad St P.o. Box 69 Bangor MI 49013-1464 Ph: (269) 427-8400 | Beacon Specialized Living Services, Inc. 555 Railroad St Bangor MI 49013-1464 Ph: (269) 427-8400 |
| NPI Number | 1790835296 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 03/31/2015 |
| Medicare PECOS PAC ID | 8527383421 |
|---|---|
| Medicare Enrollment ID | O20150218000848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790835296 | NPI | - | NPPES |
| Provider Name | Kristina Lynn Sturgill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720249667 PECOS PAC ID: 2264616010 Enrollment ID: I20110404000170 |
| Provider Name | Gerald P Wright |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1700199809 PECOS PAC ID: 5395973101 Enrollment ID: I20150218001021 |
Bronson Lakeview Family Care Bangor Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 520 Railroad St, Bangor, MI 49013 Phone: 269-427-5811 Fax: 269-427-6107 | |
Intercare Community Heath Network Medical Van Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Charles Street, Bangor, MI 49013 Phone: 269-427-7937 Fax: 269-427-5180 | |
Intercare Community Health Network Dental Van Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Charles Street, Bangor, MI 49013 Phone: 269-427-7937 Fax: 269-427-5180 | |
Beacon Specialized Living Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 Railroad St, Bangor, MI 49013 Phone: 269-427-8400 | |
Intercare Community Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Industrial Park Dr, Bangor, MI 49013 Phone: 269-427-7937 Fax: 269-427-5180 | |
Bronson South Haven Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Railroad St, Bangor, MI 49013 Phone: 269-427-5811 Fax: 269-427-6107 |