Provider Demographics
NPI:1801426671
Name:BEYOND HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BEYOND HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUINTIN
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:YAZZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-637-3464
Mailing Address - Street 1:4914 E CORONADO RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4218
Mailing Address - Country:US
Mailing Address - Phone:928-637-3464
Mailing Address - Fax:
Practice Address - Street 1:2942 N 24TH ST STE 204
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7850
Practice Address - Country:US
Practice Address - Phone:575-208-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEYOND TRANSPORT SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care