Provider Demographics
NPI:1356719801
Name:ABOVE & BEYOND
Entity type:Organization
Organization Name:ABOVE & BEYOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-420-5396
Mailing Address - Street 1:1877 EL RANCHO DR
Mailing Address - Street 2:APT 171
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-8529
Mailing Address - Country:US
Mailing Address - Phone:775-379-8918
Mailing Address - Fax:
Practice Address - Street 1:1877 EL RANCHO DR
Practice Address - Street 2:APT 171
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-8529
Practice Address - Country:US
Practice Address - Phone:775-379-8918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151498678320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness