Healthcare Provider Details

I. General information

NPI: 1396023123
Provider Name (Legal Business Name): EXTREME QUALITY HOME HEALTH CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 09/06/2023
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12995 S CLEVELAND AVE STE 232
FORT MYERS FL
33907-3809
US

IV. Provider business mailing address

12995 S CLEVELAND AVE STE 232
FORT MYERS FL
33907-3809
US

V. Phone/Fax

Practice location:
  • Phone: 239-288-4951
  • Fax: 239-288-4961
Mailing address:
  • Phone: 239-288-4951
  • Fax: 239-288-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. HARI SHANTHAN NAGI REDDY
Title or Position: PRESIDENT
Credential:
Phone: 317-652-1584