Provider Demographics
NPI:1801393996
Name:ABOVE & BEYOND CARE BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ABOVE & BEYOND CARE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:419-243-2273
Mailing Address - Street 1:701 JEFFERSON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-6957
Mailing Address - Country:US
Mailing Address - Phone:419-243-2273
Mailing Address - Fax:567-318-5448
Practice Address - Street 1:701 JEFFERSON AVE STE 202
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-6957
Practice Address - Country:US
Practice Address - Phone:419-243-2273
Practice Address - Fax:567-318-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health