Provider Demographics
NPI:1891986758
Name:ABOVE AND BEYOND PROVIDERS LLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SONNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-778-5635
Mailing Address - Street 1:1986 DALLAS DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1400
Mailing Address - Country:US
Mailing Address - Phone:225-778-5635
Mailing Address - Fax:225-778-5632
Practice Address - Street 1:1986 DALLAS DR
Practice Address - Street 2:SUITE 3
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1400
Practice Address - Country:US
Practice Address - Phone:225-778-5635
Practice Address - Fax:225-778-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1720844171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1720844MedicaidPCS