Beacon House LLC
Family Medicine in Tooele, UT. Organization (NPI-2).
NPI number1740094895
StatusActive
Last updated in NPPESFeb 6, 2025
Details
- NPI
- 1740094895
- Entity type
- Organization (NPI-2)
- Legal business name
- Beacon House LLC
- Organization subpart
- Yes
- Enumeration date
- Feb 6, 2025
- Certification date
- Feb 6, 2025
- Last updated
- Feb 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
60 S Main St Ste 6Tooele, UT 84074-2136
Phone 435-255-6150
Mailing address
60 S Main St Ste 6Tooele, UT 84074-2136
Authorized official
Holly Ren'Ee Jones
Owner
4358402602
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