Healthcare Provider Details
I. General information
NPI: 1821451261
Provider Name (Legal Business Name): EXTENDED ARMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2016
Last Update Date: 08/02/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7225 COLERAIN AVE SUITE 202
CINCINNATI OH
45239-5364
US
IV. Provider business mailing address
7225 COLERAIN AVE SUITE 202
CINCINNATI OH
45239-5364
US
V. Phone/Fax
- Phone: 513-394-1564
- Fax: 513-672-2069
- Phone: 513-394-1564
- Fax: 513-672-2069
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ALLISON
DEAN
WATSON
Title or Position: CEO
Credential:
Phone: 513-394-1564