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BEACON SPECIALIZED LIVING OHIO INC
NPI 1265131064
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Fairborn, OH

Active since March 01, 2023
1460 GRACELAND DR, FAIRBORN, OH 45324(937) 874-5001 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Beacon Specialized Living Ohio Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACON SPECIALIZED LIVING OHIO INC (NPI 1265131064) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Fairborn, Ohio and active in the NPI registry since March 2023. The organization lists Janet Pell, Vp Of Ops And Business Development, as its authorized official.

NPPES Registry Identity

NPI1265131064
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameBEACON SPECIALIZED LIVING OHIO INC
Location Address1460 GRACELAND DRFairborn, OH 45324-4374
Mailing Address967 Worthington Woods Loop RdWorthington, OH 43085-5743
Phone(937) 874-5001
Organization SubpartYesParent: Keystone Community Resources
Authorized OfficialJanet PellVp Of Ops And Business Development · (614) 330-3073
Enumeration DateMarch 1, 2023
NPPES CertifiedMarch 1, 2023
✔ NPI 1265131064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
1460 GRACELAND DR, Fairborn, OH 45324
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Other Names 2

Other NameBeacon Services Holdings, Inc.
Other NameBeacon Specialized Living

Other Identifiers 1

Other2916025OH · Ohio Department Of Developmental Disabilities

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LETESE BURG
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
JOYCE BURROUGHS
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
I AM BOUNDLESS, INC
Intermediate Care Facility, Intellectual Disabilities
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
JULISA VICROY
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
CHRISTOPER HERISE
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
TRAVISHAY KENNEDY
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
NAKESHA GAINEY
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800
MYKALAL THOMPSON
Case Manager/Care Coordinator
1460 GRACELAND DR
FAIRBORN, OH 45324
Greene County (614) 844-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beacon Specialized Living Ohio Inc's NPI number?

The NPI number for Beacon Specialized Living Ohio Inc is 1265131064. It was assigned to this organization in the NPPES registry on March 1, 2023. The provider is also known as Beacon Services Holdings, Inc. and Beacon Specialized Living.

Where is Beacon Specialized Living Ohio Inc located?

Beacon Specialized Living Ohio Inc is located at 1460 Graceland Dr, Fairborn, OH 45324. The listed phone number is (937) 874-5001.

What is Beacon Specialized Living Ohio Inc's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Beacon Specialized Living Ohio Inc was last updated on March 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.