Provider Demographics
NPI:1225366958
Name:BEYONDFAITH HOMECARE & REHAB OF FT WORTH, LLC
Entity Type:Organization
Organization Name:BEYONDFAITH HOMECARE & REHAB OF FT WORTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-408-7096
Mailing Address - Street 1:5601 EXECUTIVE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2508
Mailing Address - Country:US
Mailing Address - Phone:972-677-3499
Mailing Address - Fax:
Practice Address - Street 1:107 LARSON LN STE 200
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-4593
Practice Address - Country:US
Practice Address - Phone:817-441-2747
Practice Address - Fax:817-441-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX013230251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747521OtherMEDICARE PROVIDER NUMBER