Provider Demographics
NPI:1346247434
Name:BEYONDFAITH HOMECARE & REHAB, LLC
Entity Type:Organization
Organization Name:BEYONDFAITH HOMECARE & REHAB, LLC
Other - Org Name:BEYONDFAITH HOMECARE & REHAB OF WICHITA FALLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-283-6243
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 1:6410 98TH STREET
Practice Address - Street 2:STE 200
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-798-5683
Practice Address - Fax:806-798-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162453801Medicaid
TX162453803Medicaid
45D1017319OtherCLIA
TX162453802Medicaid
TX679374Medicare Oscar/Certification