institution
Beacon Medical Group, Inc.
Mental Health Clinic/Center (Including Community Mental Health Center) in Elkhart, Indiana
NPI 1538265863

Beacon Medical Group, Inc. is a Mental Health Clinic/Center (Including Community Mental Health Center) based in South Bend, IN and is specialized in Mental Health (Including Community Mental Health Center). Beacon Medical Group, Inc. practices in Elkhart, IN. The NPI Number for Beacon Medical Group, Inc. is 1538265863 and holds a License No. 06-005017-1 (Indiana).

The current practice location address for Beacon Medical Group, Inc. is 1506 Osolo Rd, Elkhart, IN and can be reached out via phone at 574-523-3347 and via fax at 574-206-9502. You can also correspond with Beacon Medical Group, Inc. through the mailing address at 710 N NILES AVE, SOUTH BEND, IN - 46617-1924 (mailing address contact number: 574-647-1610).

Location: 1506 Osolo Rd, Elkhart, IN, 46617-1924
institution
Provider Profile Details
NPI Number
1538265863
Provider Name
Beacon Medical Group, Inc.
Credential
Provider Entity Type
Organization
Address
1506 Osolo Rd, Elkhart, IN, 46617-1924
Phone Number
574-523-3347
Fax Number
574-206-9502
Provider Enumeration Date
09/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000110756 01 IN ANTHEM BCBS
000000075060 01 IN ANTHEM BCBS-MSW
100268350A 05 IN
institution
Provider Business Practice Location Address Details
Address
1506 Osolo Rd
City
State
Zip
46514-4122
Phone Number
574-523-3347
Fax Number
574-206-9502
person
Provider Business Mailing Address Details
Address
710 N Niles Ave
City
State
Zip
46617-1924
Phone Number
574-647-1610
Fax Number
574-237-6069
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
06-005017-1 (Indiana)
Definition
Definition to come...
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