Provider Demographics
NPI:1679826382
Name:ABOVE AND BEYOND CONSUMER DIRECTED SERVICES CORP
Entity Type:Organization
Organization Name:ABOVE AND BEYOND CONSUMER DIRECTED SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-435-6925
Mailing Address - Street 1:23 PATRICIA AVE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2955
Mailing Address - Country:US
Mailing Address - Phone:314-435-6925
Mailing Address - Fax:314-228-0007
Practice Address - Street 1:9953 LEWIS AND CLARK BLVD
Practice Address - Street 2:307D
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136
Practice Address - Country:US
Practice Address - Phone:314-435-6925
Practice Address - Fax:314-228-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health