Healthcare Provider Details

I. General information

NPI: 1134355043
Provider Name (Legal Business Name): BEYOND BOUNDARIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 PEYTON STREET
WARD AR
72176
US

IV. Provider business mailing address

PO BOX 333
WARD AR
72176-0333
US

V. Phone/Fax

Practice location:
  • Phone: 501-941-5630
  • Fax:
Mailing address:
  • Phone: 501-941-5630
  • Fax: 501-843-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BETH STAMP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 501-912-6403