institution
Beach Club Residential Living Inc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Geneva, Ohio
NPI 1740404870

Beach Club Residential Living Inc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Geneva, OH. Beach Club Residential Living Inc practices in Geneva, OH. The NPI Number for Beach Club Residential Living Inc is 1740404870 and holds a License No. 2056975 (Ohio).

The current practice location address for Beach Club Residential Living Inc is 5254 Lake Rd E, Geneva, OH and can be reached out via phone at 440-466-0988 and via fax at 440-466-0315.

Location: 5254 Lake Rd E, Geneva, OH, 44041-9490
institution
Provider Profile Details
NPI Number
1740404870
Provider Name
Beach Club Residential Living Inc
Credential
Provider Entity Type
Organization
Address
5254 Lake Rd E, Geneva, OH, 44041-9490
Phone Number
440-466-0988
Fax Number
440-466-0315
Provider Enumeration Date
04/12/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0400355 01 OH CONTRACT NUMBER
2056975 05 OH
institution
Provider Business Practice Location Address Details
Address
5254 Lake Rd E
City
State
Zip
44041-9490
Phone Number
440-466-0988
Fax Number
440-466-0315
person
Provider Business Mailing Address Details
Address
5254 Lake Rd E
City
State
Zip
44041-9490
Phone Number
440-466-0988
Fax Number
440-466-0315
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
2056975 (Ohio)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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