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General NPI Number Information
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NPI Number | 1134919749
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Entity Type | Organization
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Legal Business Name | ABOVE AND BEYOND SENIOR CARE LLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 2027 BUR OAK PL
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City | STOCKTON
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State | CA
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Zip | 95206-6386
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Country | US
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Telephone | 209-918-7694
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Fax |
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Provider Business Mailing Address
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Address Line | 231 MARKET PL STE 316
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City | SAN RAMON
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State | CA
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Zip | 94583-4743
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Country | US
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Telephone | 925-999-5666
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Fax |
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Authorized Official
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Title or Position | LLC MEMBER
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Name | MELISSA PHANOUVONG
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Credential |
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Telephone | 209-918-7694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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