Organization · NPI-2

Beacon Outreach Initiatives LLC

Respite Care · Los Angeles, CA

NPI number1699594812

StatusActive

Last updated in NPPESOct 4, 2024

Details

NPI: 1699594812
Entity type: Organization (NPI-2)
Legal business name: Beacon Outreach Initiatives LLC
Organization subpart: No
Enumeration date: Oct 4, 2024
Certification date: Oct 2, 2024
Last updated: Oct 4, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
385H00000X	Respite Care	–	–	Yes
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–

Practice location

619 E 116th Pl
Los Angeles, CA 90059-2311

Phone 714-864-0735

Mailing address

1717 West 85th Street
La, CA 90048

Phone 323-472-7784

Authorized official

Kobina S Sackey
Operations Manager
7148640735

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