MEDICARE: ABOVE & BEYOND HEALTHCARE AGENCY 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	376J00000X	Homemaker
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1962272815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE & BEYOND HEALTHCARE AGENCY LLC

Provider Business Mailing Address
First Line	:	24700 AURORA RD STE 4
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1786
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24700 AURORA RD STE 4
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1786
Country	:	US
Telephone Number	:	216-357-1414
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. RODNEY JOHNSON JR.
Credential	:	RN
Telephone Number	:	216-357-1414

Provider Enumeration Date	:	01/02/2024
Last Update Date	:	01/02/2024

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