Provider Demographics
NPI:1972240828
Name:ABOVE AND BEYOND HEALTHCARE STAFFING AGENCY LLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND HEALTHCARE STAFFING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-931-1382
Mailing Address - Street 1:3190 CRESTMONT WAY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4682
Mailing Address - Country:US
Mailing Address - Phone:167-879-9553
Mailing Address - Fax:
Practice Address - Street 1:157 S FAIRGROUND ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2388
Practice Address - Country:US
Practice Address - Phone:678-799-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care