Healthcare Provider Details
I. General information
NPI: 1265351712
Provider Name (Legal Business Name): WAY ABOVE ABA AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1120 W UNIVERSITY AVE FL 2
FLAGSTAFF AZ
86001-2851
US
IV. Provider business mailing address
120 W UNIVERSITY AVE 2ND FLOOR
FLAGSTAFF AZ
86001-2851
US
V. Phone/Fax
- Phone: 305-375-1475
- Fax:
- Phone: 305-375-1475
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MORDECHAI
SCHWEID
Title or Position: MANAGING MEMBER
Credential:
Phone: 305-375-1475