Healthcare Provider Details

I. General information

NPI: 1285152041
Provider Name (Legal Business Name): ABOVE AND BEYOND HOME HEALTH CARES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7251 OLIVE
ST LOUIS MO
63130
US

IV. Provider business mailing address

7251 OLIVE BLVD
SAINT LOUIS MO
63130-2322
US

V. Phone/Fax

Practice location:
  • Phone: 314-749-7618
  • Fax: 314-862-6155
Mailing address:
  • Phone: 314-749-7618
  • Fax: 314-862-6155

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: IESHA JOSEPH
Title or Position: OWNER
Credential:
Phone: 314-749-7618