MEDICARE: EXTENDED FAMILY HOME CARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	385H00000X	Respite Care
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1760023501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXTENDED FAMILY HOME CARE SERVICES

Provider Business Mailing Address
First Line	:	301 N GUM ST
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-6861
Country	:	US
Telephone Number	:	843-608-9048
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 RIVERS AVE STE A
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-7067
Country	:	US
Telephone Number	:	843-608-9048
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KAI-RENAY SCOTT
Credential	:
Telephone Number	:	843-608-9048

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	10/02/2019

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Directions to “EXTENDED FAMILY HOME CARE SERVICES ” Practice Location

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