A Life Renewed

LBN: Beacon St. Psychiatry
A Life Renewed is an health care organization with primary practice located at 10552 Success Ln Ste L , Centerville OH 45458-3664. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as the primary health care specialty. Beacon St. Psychiatry can be contacted via phone (937) 280-5711, or through Gibson, Brad via phone (937) 280-5711.

Contact Information

Primary practice address
10552 Success Ln Ste L Centerville OH 45458-3664
Phone: (937) 280-5711
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gibson, Brad MBA, MSN, APRN
Phone: (937) 280-5711

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1780460006
LBN Legal business name Beacon St. Psychiatry
DBA Doing business as A Life Renewed
Authorized official Gibson, Brad MBA, MSN, APRN
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2023
Last updated Jan 24th, 2024 - about 11 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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