Provider Demographics
NPI:1831556786
Name:ABOVE AND BEYOND COMMUNITY SERVICES
Entity type:Organization
Organization Name:ABOVE AND BEYOND COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-841-9972
Mailing Address - Street 1:305 CHURCH ST
Mailing Address - Street 2:UNIT 5
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-2836
Mailing Address - Country:US
Mailing Address - Phone:203-723-7777
Mailing Address - Fax:203-729-4444
Practice Address - Street 1:305 CHURCH ST
Practice Address - Street 2:UNIT 5
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-2836
Practice Address - Country:US
Practice Address - Phone:203-723-7777
Practice Address - Fax:203-729-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-23
Last Update Date:2016-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health