Provider Demographics
NPI:1003226630
Name:BEYOND INDEPENDENT LIVING LLC
Entity Type:Organization
Organization Name:BEYOND INDEPENDENT LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAGIEDE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PROGRAM DIRECTOR
Authorized Official - Phone:781-281-1117
Mailing Address - Street 1:1208B VFW PARKWAY,
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02132
Mailing Address - Country:US
Mailing Address - Phone:781-932-1166
Mailing Address - Fax:781-932-1154
Practice Address - Street 1:1208B VFW PARKWAY,
Practice Address - Street 2:SUITE 301
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132
Practice Address - Country:US
Practice Address - Phone:781-281-1117
Practice Address - Fax:781-281-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management