Provider Demographics
NPI:1932701596
Name:BEYOND PALLIATIVE & HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:BEYOND PALLIATIVE & HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-550-3626
Mailing Address - Street 1:4002 HIGHLAND VALE CT
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7022
Mailing Address - Country:US
Mailing Address - Phone:713-550-3626
Mailing Address - Fax:
Practice Address - Street 1:4002 HIGHLAND VALE CT
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7022
Practice Address - Country:US
Practice Address - Phone:713-550-3626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based