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General NPI Number Information
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NPI Number | 1700120383
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Entity Type | Organization
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Legal Business Name | ABOVE & BEYOND HOME CARE INC
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Dates
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Enumeration Date | 11/20/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 2379 HIGHWAY 62 412 SUITE H
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City | HIGHLAND
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State | AR
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Zip | 72542-9393
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Country | US
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Telephone | 870-856-3030
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Fax | 870-856-3033
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Provider Business Mailing Address
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Address Line | 206 CAMP RD
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City | POCAHONTAS
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State | AR
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Zip | 72455-1363
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Country | US
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Telephone | 870-609-1906
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Fax | 870-609-1907
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. GARY JOHNSON
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Credential |
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Telephone | 870-609-1906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | AR4821
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License Number State | AR
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