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General NPI Number Information
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NPI Number | 1629996939
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Entity Type | Organization
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Legal Business Name | UP NEXT DIRECT LLC
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 1601 W 165TH ST
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City | COMPTON
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State | CA
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Zip | 90220-4315
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Country | US
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Telephone | 323-353-8154
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CONTINENTAL BLVD STE 6084
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City | EL SEGUNDO
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State | CA
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Zip | 90245-5076
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Country | US
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Telephone | 323-353-8154
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMELA BONESHA BEAVERS
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Credential |
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Telephone | 323-353-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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