BEACH CLUB RESIDENTIAL LIVING INC – NPI #1740404870
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

BEACH CLUB RESIDENTIAL LIVING INC is a community based residential treatment facility located in GENEVA, OH. NPPES has assigned the NPI number 1740404870 to BEACH CLUB RESIDENTIAL LIVING INC on April 12, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BEACH CLUB RESIDENTIAL LIVING INC below.

NPI Profile for
BEACH CLUB RESIDENTIAL LIVING INC

NPI Number
1740404870
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BEACH CLUB RESIDENTIAL LIVING INC
Primary location
5254 LAKE RD E
SUITE #3
GENEVA, OH 44041-9490
Phone: (440) 466-0988 Fax: (440) 466-0315
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LUANN BUSCH
OWNER
Phone: (440) 466-0988
Updated
Identifiers

Identifiers for BEACH CLUB RESIDENTIAL LIVING INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCONTRACT NUMBEROH0400355
MEDICAIDOH2056975
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
OH 2056975

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.