=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467334151
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABOVE AND BEYOND CARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2025
-----------------------------------------------------
Last Update Date | 07/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6570 CORBITT AVE
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63130-2602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-210-4688
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1891 CHATEAU DU MONT DR
-----------------------------------------------------
City | FLORISSANT
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63031-1053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-210-4688
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | TRACY THOMAS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 314-210-4688
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320900000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------