Healthcare Provider Details

I. General information

NPI: 1003226630
Provider Name (Legal Business Name): BEYOND INDEPENDENT LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 CENTRE ST
BROCKTON MA
02302-3357
US

IV. Provider business mailing address

661 CENTRE ST
BROCKTON MA
02302-3357
US

V. Phone/Fax

Practice location:
  • Phone: 781-281-1117
  • Fax: 781-281-2275
Mailing address:
  • Phone: 781-932-1166
  • Fax: 781-932-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: NAOMI OSAGIEDE
Title or Position: OWNER
Credential: RN, PROGRAM DIRECTOR
Phone: 781-281-1117