Provider Demographics
NPI:1104932250
Name:BEACON GROUP, INC.
Entity type:Organization
Organization Name:BEACON GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:520-622-4874
Mailing Address - Street 1:308 W GLENN ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-4433
Mailing Address - Country:US
Mailing Address - Phone:520-622-4874
Mailing Address - Fax:520-620-6620
Practice Address - Street 1:308 W GLENN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705
Practice Address - Country:US
Practice Address - Phone:520-622-4874
Practice Address - Fax:520-620-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ634495OtherARIZONA DEPARTMENT OF DEVELOPEMENTAL DISABILITIES
AZ113035OtherPIMA HEALTH SYSTEM