Provider Demographics
NPI:1053029678
Name:BEYOND INTENSIVE OUTPATIENT PROGRAM, LLC
Entity type:Organization
Organization Name:BEYOND INTENSIVE OUTPATIENT PROGRAM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEMEELA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:225-930-5056
Mailing Address - Street 1:8040 STONESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-5762
Mailing Address - Country:US
Mailing Address - Phone:225-223-0365
Mailing Address - Fax:
Practice Address - Street 1:7485 OAKLEAF DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70812-3728
Practice Address - Country:US
Practice Address - Phone:225-223-0365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder