Provider Demographics
NPI:1619928959
Name:BEYONDFAITH HOMECARE & REHAB OF GRAHAM, LLC
Entity Type:Organization
Organization Name:BEYONDFAITH HOMECARE & REHAB OF GRAHAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DEAN
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 1:604 OAK ST
Practice Address - Street 2:#102
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3070
Practice Address - Country:US
Practice Address - Phone:940-521-0300
Practice Address - Fax:940-521-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180082301Medicaid