Provider Demographics
NPI:1750775433
Name:BEYOND COMPANION HOME CARE LLC
Entity type:Organization
Organization Name:BEYOND COMPANION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DABNEY
Authorized Official - Suffix:
Authorized Official - Credentials:AAS MA
Authorized Official - Phone:540-408-7850
Mailing Address - Street 1:13939 ANDORRA DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-2353
Mailing Address - Country:US
Mailing Address - Phone:571-408-1452
Mailing Address - Fax:571-589-8969
Practice Address - Street 1:13939 ANDORRA DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2353
Practice Address - Country:US
Practice Address - Phone:571-408-1452
Practice Address - Fax:571-589-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2015106955Medicaid