MEDICARE: BEYOND CARE HOME HEALTH 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	012462	TX

General Provider Information

NPI Number	:	1598917445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND CARE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	2801 E MONTGOMERY ST STE 206
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78043-1402
Country	:	US
Telephone Number	:	956-712-3667
Fax Number	:	956-722-3368

Provider Business Practice Location Address
First Line	:	2801 E MONTGOMERY ST STE 206
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78043-1402
Country	:	US
Telephone Number	:	956-712-3667
Fax Number	:	956-722-3368

Authorized Official
Title or Position	:	ADMINISTRATOR/CO-OWNER
Name	:	REYES GERARDO SOTO
Credential	:	R.N.
Telephone Number	:	956-712-3667

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	10/27/2009

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