Provider Demographics
NPI:1215382312
Name:INFINITY & BEYOND L. C.
Entity Type:Organization
Organization Name:INFINITY & BEYOND L. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAJUANA
Authorized Official - Middle Name:TEKEIA
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECT CARE WORKER
Authorized Official - Phone:248-587-6502
Mailing Address - Street 1:19182 WAKENDEN
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1445
Mailing Address - Country:US
Mailing Address - Phone:248-587-6502
Mailing Address - Fax:
Practice Address - Street 1:19182 WAKENDEN
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240
Practice Address - Country:US
Practice Address - Phone:248-587-6502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE7963H253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care