Provider Demographics
NPI:1760865620
Name:ABOVE & BEYOND-HIGHLAND LLC
Entity Type:Organization
Organization Name:ABOVE & BEYOND-HIGHLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:THIELEMIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-658-9758
Mailing Address - Street 1:2379 HIGHWAY 62 412 STE H
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9391
Mailing Address - Country:US
Mailing Address - Phone:870-856-3030
Mailing Address - Fax:870-856-3033
Practice Address - Street 1:2379 HIGHWAY 62 412 STE H
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542-9391
Practice Address - Country:US
Practice Address - Phone:870-856-3030
Practice Address - Fax:870-856-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR5095253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR206782752Medicaid
AR206785732Medicaid
AR206784796Medicaid
AR206774797Medicaid
AR206783757Medicaid