Healthcare Provider Details

I. General information

NPI: 1467210427
Provider Name (Legal Business Name): BEYOND INFINITY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 03/13/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13602 N. 44TH ST APT 274
PHOENIX AZ
85032
US

IV. Provider business mailing address

3218 E BELL RD
PHOENIX AZ
85032-2727
US

V. Phone/Fax

Practice location:
  • Phone: 623-272-4510
  • Fax:
Mailing address:
  • Phone: 623-272-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHANEL M HARRIS
Title or Position: OWNER/CEO/PRESIDENT
Credential:
Phone: 623-272-4510