Organization Active NPI

Above and Beyond Enterprise

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Kings Mountain, NC
National Provider Identifier
1205996899
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-023-108 Issued in NC
Legal business name
ABOVE AND BEYOND ENTERPRISE
Practice address
104 S Carpenter St
Kings Mountain, NC 28086-3415
Phone
(704) 734-1040
Fax
(704) 734-1095
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Lonnie James Tucker Jr.
Title
Ceo
Phone
(704) 734-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-023-108 NC Primary

Addresses

Primary practice location

104 S Carpenter St
Kings Mountain, NC 28086-3415

Mailing address

PO Box 682
Kings Mountain, NC 28086-0682
Phone (704) 734-1040

Other identifiers 1

IdentifierTypeStateIssuer
6603537MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Above and Beyond Enterprieses2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

104 S Carpenter St
Kings Mountain, NC 28086
Phone (704) 734-1040

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205996899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 682",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280860682",
            "telephone_number": "704-734-1040",
            "fax_number": "704-734-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S CARPENTER ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280863415",
            "telephone_number": "704-734-1040",
            "fax_number": "704-734-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABOVE AND BEYOND ENTERPRISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-734-1040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-023-108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603537",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.