| NPI | 1437100161 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP SOUTHEAST NEIGHBORHOOD HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFFREY COSTELLO VP CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01059718A) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2016-08-29 |