Provider Demographics
NPI:1972922300
Name:ABOVE AND BEYOND HOME CARE OF CENTRAL ARKANSAS
Entity Type:Organization
Organization Name:ABOVE AND BEYOND HOME CARE OF CENTRAL ARKANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSCOVALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:501-366-4163
Mailing Address - Street 1:1202 MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-5057
Mailing Address - Country:US
Mailing Address - Phone:501-374-2909
Mailing Address - Fax:501-374-2913
Practice Address - Street 1:1202 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-5057
Practice Address - Country:US
Practice Address - Phone:501-374-2909
Practice Address - Fax:501-374-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care