Healthcare Provider Details

I. General information

NPI: 1407402787
Provider Name (Legal Business Name): EXTENSIVE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 E MAIN ST STE 112
NEWARK DE
19711-7324
US

IV. Provider business mailing address

280 E MAIN ST STE 112
NEWARK DE
19711-7324
US

V. Phone/Fax

Practice location:
  • Phone: 302-696-5511
  • Fax: 302-286-7382
Mailing address:
  • Phone: 302-294-6250
  • Fax: 302-294-6457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KAREEMAH HAMMOND
Title or Position: PROVIDER
Credential: APRN
Phone: 302-294-6250