MEDICARE: BEYOND HOME HEALTH SERVICES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1306615919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	4010 HIGHLAND VALE CT
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-7023
Country	:	US
Telephone Number	:	713-550-3626
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 HIGHLAND VALE CT
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-7023
Country	:	US
Telephone Number	:	713-550-3626
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROLYN MICKENS
Credential	:
Telephone Number	:	713-550-3626

Provider Enumeration Date	:	12/22/2023
Last Update Date	:	12/22/2023

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