MEDICARE: ABOVE AND BEYOND HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	2203782383	LA

General Provider Information

NPI Number	:	1235513706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE AND BEYOND HOME CARE

Provider Business Mailing Address
First Line	:	1605 BROAD ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-4602
Country	:	US
Telephone Number	:	337-564-5341
Fax Number	:	337-564-5361

Provider Business Practice Location Address
First Line	:	1605 BROAD ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-4602
Country	:	US
Telephone Number	:	337-564-5341
Fax Number	:	337-564-5361

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	GWENDOLYN MARIE LEVINGS
Credential	:
Telephone Number	:	337-564-5341

Provider Enumeration Date	:	07/15/2015
Last Update Date	:	07/15/2015

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Directions to “ABOVE AND BEYOND HOME CARE ” Practice Location

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