BEACON OF LIFE (ACUTECARE HEALTH SYSTEM) NPI 1942678396

Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Oceanport, NJ

NPI 1942678396 Organization Program of All-Inclusive Care for the El...

About BEACON OF LIFE (ACUTECARE HEALTH SYSTEM)

Beacon Of Life (acutecare Health System) is a provider established in Oceanport, New Jersey specializing in program of all-inclusive care for the elderly (pace) provider organization. The NPI number of Beacon Of Life (acutecare Health System) is 1942678396 and was assigned on September 2015. The practitioner's primary taxonomy code is 251T00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Beacon Of Life. The authorized official of this NPI record is Daniel Czermak (President)

NPI

1942678396

Provider NameBEACON OF LIFE (ACUTECARE HEALTH SYSTEM)
Provider Location Address1075 STEPHENSON AVE OCEANPORT, NJ 07757
Provider Mailing Address1075 STEPHENSON AVE OCEANPORT, NJ 07757
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameBEACON OF LIFE
Other Name TypeDoing Business As (3)
Enumeration Date09-02-2015
Last Update Date11-16-2017


Primary Taxonomy

Taxonomy Code251T00000X
ClassificationProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
TypeAgencies
Taxonomy DescriptionA PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

Business Address

BEACON OF LIFE
1075 STEPHENSON AVE
OCEANPORT, NJ
ZIP 07757
Phone: (732) 806-3223
Fax: (732) 806-3224

Get Directions


Mailing Address

BEACON OF LIFE
1075 STEPHENSON AVE
OCEANPORT, NJ
ZIP 07757
Phone: (732) 806-3223
Fax: (732) 806-3224



Authorized Official

Authorized Official Name DANIEL CZERMAK
Authorized Official TitlePRESIDENT
Authorized Official Phone(732) 806-3223

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
H9323MEDICARE UPIN (02)NJ

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104499409MS. REBECCA FLORENCE MIZRAHI APN
Individual
Nurse Practitioner (Psychiatric/Mental Health)1075 STEPHENSON AVE
OCEANPORT, NJ 07757
(848) 208-2636
1215601307 SHARISA LOVICK
Individual
Nurse Practitioner1075 STEPHENSON AVE
OCEANPORT, NJ 07757
(732) 592-3400

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.