| Beacon Medical Group Behavioral Health South Bend | |
|
707 N Michigan St Ste 400 South Bend IN 46601-1071 | |
| (574) 647-8470 | |
| (574) 647-8475 |
| Full Name | Beacon Medical Group Behavioral Health South Bend |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 707 N Michigan St Ste 400, South Bend, Indiana |
| Authorized Official Name and Position | Jeffrey P Costello (VP/CFO) |
| Authorized Official Contact | 5746473549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Medical Group Behavioral Health South Bend 710 N Niles Ave South Bend IN 46617-1924 Ph: (574) 647-1610 | Beacon Medical Group Behavioral Health South Bend 707 N Michigan St Ste 400 South Bend IN 46601-1071 Ph: (574) 647-8470 |
| NPI Number | 1629376645 |
|---|---|
| Provider Enumeration Date | 03/01/2011 |
| Last Update Date | 02/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629376645 | NPI | - | NPPES |
| 201013730A | Medicaid | IN |
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