OrganizationActive
Beach Club Residential Living Inc
NPI 1740404870 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Geneva, OH
Provider details
- NPI number
- 1740404870
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Luann Busch, Owner(440) 466-0988
- License
- 2056975 (OH)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 2056975 (OH)
Residential Treatment Facilities
Practice location
5254 Lake Rd E
Suite #3
Geneva, OH 44041-9490
Phone: (440) 466-0988
Fax: (440) 466-0315
Approximate (ZIP-level) locationGet directions
Mailing address
5254 Lake Rd E
Geneva, OH 44041-9490
Registry dates
- Enumerated
- 2007-04-12
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.