Basic Information
| Provider Information | |||||||||
| NPI: | 1215682109 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BECKETT SPRINGS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8614 SHEPHERD FARM DR | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450691128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139429500 | ||||||||
| FaxNumber: | 5139429501 | ||||||||
| Practice Location | |||||||||
| Address1: | 4896 WUNNENBERG WAY | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450694863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139992599 | ||||||||
| FaxNumber: | 5138160001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2022 | ||||||||
| LastUpdateDate: | 02/18/2022 | ||||||||
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| AuthorizedOfficialLastName: | FASELLE | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8178818612 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BECKETT SPRINGS, LLC | ||||||||
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| NPICertificationDate: | 02/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.