Organization Name: | BEACON HOSPICE, LLC |
NPI Number: | 1134203284 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL B KUSSEROW (PRESIDENT) |
Mailing Address: | 111 Founders Plz Suite 1803 East Hartford |
State: | CT US |
Postal Code: | 061083212 |
Phone Number: | 8602820527 |
Fax Number: | 8602824692 |
NPI Enumeration Date: | 10/25/2006 |
NPI Last Update Date: | 07/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 0024 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |