Healthcare Provider Details

I. General information

NPI: 1528752060
Provider Name (Legal Business Name): BEYOND EDUCATIONAL STAFFING AND THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 07/16/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 E LE MARCHE AVE
PHOENIX AZ
85022-3245
US

IV. Provider business mailing address

PO BOX 30759
PHOENIX AZ
85046-0759
US

V. Phone/Fax

Practice location:
  • Phone: 602-283-4121
  • Fax: 602-283-4184
Mailing address:
  • Phone: 602-283-4121
  • Fax: 602-283-4184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: JEFFREY A DOVER
Title or Position: OWNER/DIRECTOR OF OPERATIONS
Credential:
Phone: 602-283-4121