Provider Demographics
NPI:1750035903
Name:ABOVE AND BEYOND HOME CARE
Entity type:Organization
Organization Name:ABOVE AND BEYOND HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MW, LCSW
Authorized Official - Phone:804-366-9360
Mailing Address - Street 1:4 S HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23075
Mailing Address - Country:US
Mailing Address - Phone:804-573-3613
Mailing Address - Fax:804-636-6143
Practice Address - Street 1:4 S HOLLY AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23075
Practice Address - Country:US
Practice Address - Phone:804-573-3613
Practice Address - Fax:804-636-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care