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General NPI Number Information
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NPI Number | 1750683900
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Entity Type | Organization
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Legal Business Name | ABOVE AND BEYOND EXPECTATION, INC.
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Dates
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Enumeration Date | 11/20/2010
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Last Update Date | 11/20/2010
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Provider Practice Location Address
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Address Line | 3905 IVERSON ST
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City | RALEIGH
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State | NC
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Zip | 27604-4975
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Country | US
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Telephone | 919-673-2146
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Fax | 252-442-0013
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Provider Business Mailing Address
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Address Line | 2905 AUTUMN SUNSET CT
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City | RALEIGH
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State | NC
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Zip | 27616-7228
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Country | US
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Telephone | 919-673-2146
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Fax | 252-442-0013
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Authorized Official
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Title or Position | ADMINISTRATOR, VICE PRESIDENT
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Name | MRS. CAROLYN BYRD WESTERN
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Credential | CSAC, BA
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Telephone | 919-673-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL-092-165
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License Number State | NC
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