Provider Demographics
NPI:1568827376
Name:BEALFIRE STONE
Entity type:Organization
Organization Name:BEALFIRE STONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DASHAY
Authorized Official - Middle Name:SHANEL
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-250-0822
Mailing Address - Street 1:67 FORT PLEASANT AVENUE 1ST FL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108
Mailing Address - Country:US
Mailing Address - Phone:413-250-0822
Mailing Address - Fax:
Practice Address - Street 1:67 FORT PLEASANT AVE FL 1
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-1518
Practice Address - Country:US
Practice Address - Phone:413-250-0822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care