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General NPI Number Information
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NPI Number | 1447840715
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Entity Type | Organization
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Legal Business Name | ABOVE AND BEYOND CARE PROVIDERS,INC.
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 2300 S PACIFIC AVE
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City | SAN PEDRO
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State | CA
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Zip | 90731-5936
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Country | US
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Telephone | 310-521-9896
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Fax | 310-684-5490
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Provider Business Mailing Address
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Address Line | 2300 S PACIFIC AVE
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City | SAN PEDRO
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State | CA
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Zip | 90731-5936
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Country | US
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Telephone | 310-521-9896
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Fax | 310-684-5490
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Authorized Official
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Title or Position | OWNER
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Name | PATRIA MARAVILLA DUFRENNE
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Credential | RN
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Telephone | 310-521-9896
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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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