# BEVERLY 811, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861128928
- **Authorized official:** MRS. ROSLYN TAGGART (OWNER/CEO)
- **Authorized official phone:** (707) 722-2811

## Contact information

- **Practice address:** 241 W A ST, DIXON, CA 95620-3448
- **Practice address phone:** (707) 722-2811
- **Mailing address:** PO BOX 1797, VACAVILLE, CA 95696-1797
- **Mailing address phone:** (877) 796-2811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 07/29/2022
- **Last updated:** 02/06/2024