Provider Demographics
NPI:1003116021
Name:BEYOND HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:BEYOND HEALTHCARE AGENCY LLC
Other - Org Name:BEYOND HEALTHCARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADERONKE
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:OSAGIEDE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO, RN
Authorized Official - Phone:781-932-1166
Mailing Address - Street 1:1208B VFW PKWY STE 304
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4350
Mailing Address - Country:US
Mailing Address - Phone:781-932-1166
Mailing Address - Fax:781-932-1154
Practice Address - Street 1:10 NEW ENGLAND BUSINESS CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1024
Practice Address - Country:US
Practice Address - Phone:781-932-1166
Practice Address - Fax:781-932-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health