MEDICARE: ABOVE AND BEYOND HOME CARE SERVICE INC

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	HP0103300	NJ

General Provider Information

NPI Number	:	1790018349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE AND BEYOND HOME CARE SERVICE INC

Provider Business Mailing Address
First Line	:	469 CLIFTON AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-3227
Country	:	US
Telephone Number	:	201-494-4005
Fax Number	:	201-968-5888

Provider Business Practice Location Address
First Line	:	469 CLIFTON AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-3227
Country	:	US
Telephone Number	:	201-494-4005
Fax Number	:	201-968-5888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILDA DIAZ
Credential	:
Telephone Number	:	201-494-4005

Provider Enumeration Date	:	09/15/2009
Last Update Date	:	10/30/2023

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