Healthcare Provider Details

I. General information

NPI: 1245152776
Provider Name (Legal Business Name): FIVE AND BEYOND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BROOKRIDGE DR APT 12
TEXARKANA AR
71854-3338
US

IV. Provider business mailing address

2400 BROOKRIDGE DR APT 12
TEXARKANA AR
71854-3338
US

V. Phone/Fax

Practice location:
  • Phone: 903-826-7907
  • Fax:
Mailing address:
  • Phone: 903-826-7907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TABATHA MACHELLE RANDLE
Title or Position: OWNER
Credential:
Phone: 903-826-7907