Provider Demographics
NPI:1780207613
Name:BEYOND MEASURES HEALTHCARE LLC
Entity Type:Organization
Organization Name:BEYOND MEASURES HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEOSHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-366-0055
Mailing Address - Street 1:1000 COURT ST STE C
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-2668
Mailing Address - Country:US
Mailing Address - Phone:225-366-0055
Mailing Address - Fax:225-612-6880
Practice Address - Street 1:1000 COURT ST STE C
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-2668
Practice Address - Country:US
Practice Address - Phone:225-366-0055
Practice Address - Fax:225-612-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1467413Medicaid
LA1466794Medicaid
LA1467472Medicaid