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General NPI Number Information
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NPI Number | 1083134738
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Entity Type | Organization
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Legal Business Name | EXTRA HAND IN-HOME CARE, LLC
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 8439 WHITE OAK AVE STE 104
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3860
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Country | US
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Telephone | 909-360-2223
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Fax | 909-360-2293
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Provider Business Mailing Address
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Address Line | 8439 WHITE OAK AVE STE 104
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3860
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Country | US
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Telephone | 909-360-2223
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Fax | 909-360-2293
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Authorized Official
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Title or Position | PRESIDENT/ MANAGING MEMBER
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Name | MR. HARRY ELLIS GAINES
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Credential |
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Telephone | 909-360-2223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 364700044
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License Number State | CA
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