Healthcare Provider Details

I. General information

NPI: 1356150940
Provider Name (Legal Business Name): BEYOND CARE HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 VINSON RD
LAKELAND FL
33810-5479
US

IV. Provider business mailing address

13230 EARLY RUN LN
RIVERVIEW FL
33578-3389
US

V. Phone/Fax

Practice location:
  • Phone: 352-318-1216
  • Fax:
Mailing address:
  • Phone: 813-516-8796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TIERRA ANDERSON
Title or Position: OWNER
Credential:
Phone: 352-318-1216