Provider Demographics
NPI:1356641716
Name:ABOVE & BEYOND PROGRAM, INC.
Entity Type:Organization
Organization Name:ABOVE & BEYOND PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:QUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CLERGY
Authorized Official - Phone:502-472-8231
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40602-1013
Mailing Address - Country:US
Mailing Address - Phone:502-472-8231
Mailing Address - Fax:502-352-2459
Practice Address - Street 1:200 THISTLEWOOD AVE APT 402
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3360
Practice Address - Country:US
Practice Address - Phone:502-472-8231
Practice Address - Fax:502-352-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services