BEACON HOUSE NPI 1033274485

Substance Abuse Rehabilitation Facility in Pacific Grove, CA

NPI 1033274485 Organization Substance Abuse Rehabilitation Facility

About BEACON HOUSE

Beacon House is a provider established in Pacific Grove, California specializing in substance abuse rehabilitation facility. The NPI number of Beacon House is 1033274485 and was assigned on December 2006. The practitioner's primary taxonomy code is 324500000X with license number 270001AN (CA). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Mark Willison Mft (Ceo)

NPI

1033274485

Provider NameBEACON HOUSE
Provider Location Address468 PINE AVE PACIFIC GROVE, CA 93950
Provider Mailing AddressPO BOX 301 PACIFIC GROVE, CA 93950
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date12-26-2006
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code324500000X
ClassificationSubstance Abuse Rehabilitation Facility
TypeResidential Treatment Facilities
License No.270001AN
License StateCA
Taxonomy DescriptionA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Business Address

BEACON HOUSE
468 PINE AVE
PACIFIC GROVE, CA
ZIP 93950
Phone: (831) 372-2334
Fax: (831) 372-2396

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Mailing Address

BEACON HOUSE
PO BOX 301
PACIFIC GROVE, CA
ZIP 93950
Phone: (831) 372-2334
Fax: (831) 372-2396



Authorized Official

Authorized Official NameMR. MARK WILLISON MFT
Authorized Official TitleCEO
Authorized Official Phone(831) 372-2334

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1629653845SIERRA HEALTH AND WELLNESS CENTERS LLC
Organization
Substance Abuse Rehabilitation Facility468 PINE AVE
PACIFIC GROVE, CA 93950
(530) 854-4119

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.