Provider Demographics
NPI:1811730955
Name:BEYOND SUPPORT HOMECARE LLC
Entity type:Organization
Organization Name:BEYOND SUPPORT HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERD NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:TRUPHENA
Authorized Official - Last Name:ESIPILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-883-5522
Mailing Address - Street 1:127 DEWEY STREET
Mailing Address - Street 2:NONE
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026
Mailing Address - Country:US
Mailing Address - Phone:973-883-5522
Mailing Address - Fax:
Practice Address - Street 1:127 DEWEY STREET
Practice Address - Street 2:NONE
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026
Practice Address - Country:US
Practice Address - Phone:973-883-5522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child