Organization
BEYOND BORDERS & CO., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTWAN C. DAVIS MPA (CEO)
(623) 760-8345
Entity
Organization
Contact information
Practice address
7606 W APOLLO RD, LAVEEN, AZ 85339-7073
(623) 760-8345
(623) 760-8345
Mailing address
7606 W APOLLO RD, LAVEEN, AZ 85339-7073
(623) 760-8345
(623) 760-8345
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
3747A0650X
Attendant Care Provider
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
450754
AHCCCS
AZ
Enumeration date
06/24/2019
Last updated
06/24/2019
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