Provider Demographics
NPI:1235460395
Name:ABOVE & BEYOND HOME CARE LLC
Entity Type:Organization
Organization Name:ABOVE & BEYOND HOME CARE LLC
Other - Org Name:A FIRST NAME BASIS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FACKRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-677-5629
Mailing Address - Street 1:2111 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-4137
Mailing Address - Country:US
Mailing Address - Phone:870-609-1906
Mailing Address - Fax:870-609-1907
Practice Address - Street 1:206 CAMP RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-1363
Practice Address - Country:US
Practice Address - Phone:870-609-1907
Practice Address - Fax:870-609-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care