Beacon Medical Group Behavioral Health South Bend

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Behavioral Health South Bend is an health care organization with primary practice located at 707 N Michigan St Ste 400 , South Bend IN 46601-1071. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-8470, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
707 N Michigan St Ste 400 South Bend IN 46601-1071
Phone: (574) 647-8470
Fax: (574) 647-8475
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01052982A Indiana
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01052982A Indiana
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 01052982A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1629376645
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Behavioral Health South Bend
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2011
Last updated Feb 22nd, 2024 - about 9 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629376645 NPPES
Indiana MEDICAID 201013730A

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