Healthcare Provider Details

I. General information

NPI: 1447052683
Provider Name (Legal Business Name): BEYOND BASIC CARE HOME CARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 GARRETT RD
DREXEL HILL PA
19026-1008
US

IV. Provider business mailing address

2417 GARRETT RD
DREXEL HILL PA
19026-1008
US

V. Phone/Fax

Practice location:
  • Phone: 215-460-7330
  • Fax:
Mailing address:
  • Phone: 215-460-7330
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. NIKISHA LOUISE CUNNINGHAM
Title or Position: OWNER/CLINICAL SUPERVISOR
Credential: RN
Phone: 215-460-7330