Provider Demographics
NPI:1144546318
Name:BEACON ADULT FOSTER CARE, INC.
Entity type:Organization
Organization Name:BEACON ADULT FOSTER CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-202-1837
Mailing Address - Street 1:782A MAIN RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4341
Mailing Address - Country:US
Mailing Address - Phone:774-202-1837
Mailing Address - Fax:
Practice Address - Street 1:782A MAIN RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4341
Practice Address - Country:US
Practice Address - Phone:774-202-1837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management