| NPI | 1376365486 |
|---|---|
| Other Name | BEACON BRIDGE OF NORTH CAROLINA |
| Entity Type | Organization |
| Authorized Contact | ALEXANDER PETER YOUSIF CEO 984-282-6654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2024-10-29 |
| Last Update Date | 2024-12-08 |