Provider Demographics
NPI:1710301403
Name:BEYOND CARE HOME SERVICES LLC
Entity Type:Organization
Organization Name:BEYOND CARE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-556-4600
Mailing Address - Street 1:941 MARYVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-2416
Mailing Address - Country:US
Mailing Address - Phone:314-556-4600
Mailing Address - Fax:314-664-1259
Practice Address - Street 1:941 MARYVILLE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2416
Practice Address - Country:US
Practice Address - Phone:314-556-4600
Practice Address - Fax:314-664-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC9733403251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care