Healthcare Provider Details

I. General information

NPI: 1366058240
Provider Name (Legal Business Name): BEYOND REHAB AT YOUR SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3822 PINE NEEDLES RD
FLORENCE SC
29501-8522
US

IV. Provider business mailing address

3822 PINE NEEDLES RD
FLORENCE SC
29501-8522
US

V. Phone/Fax

Practice location:
  • Phone: 843-845-7243
  • Fax:
Mailing address:
  • Phone: 843-845-7243
  • 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 Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CARANDA ALICIA CRIBB
Title or Position: OT
Credential: OTR/L
Phone: 843-845-7243