Provider Demographics
NPI:1497272066
Name:ABOVE AND BEYOND HOMECARE SERVICES, INC.
Entity Type:Organization
Organization Name:ABOVE AND BEYOND HOMECARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LUCILLE
Authorized Official - Last Name:MACKLEM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:810-531-7996
Mailing Address - Street 1:4275 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3725
Mailing Address - Country:US
Mailing Address - Phone:810-531-7996
Mailing Address - Fax:
Practice Address - Street 1:4275 PARKER RD
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3725
Practice Address - Country:US
Practice Address - Phone:810-531-7996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health