OrganizationActive
Beacon Medical Group, Inc.
NPI 1538265863 · Mental Health Clinic/Center (Including Community Mental Health Center) · Elkhart, IN
Provider details
- NPI number
- 1538265863
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jeffrey Costello, Cfo(574) 647-3549
- License
- 06-005017-1 (IN)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense 06-005017-1 (IN)
Ambulatory Health Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1506 Osolo Rd
Suite a
Elkhart, IN 46514-4122
Phone: (574) 523-3347
Fax: (574) 206-9502
Street-level locationGet directions
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Other names (DBA / former)
- Other name
- Beacon Medical Group Behavioral Health Elkhart
Registry dates
- Enumerated
- 2006-09-15
- Last updated
- 2016-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.