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General NPI Number Information
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NPI Number | 1124696604
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Entity Type | Organization
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Legal Business Name | ASSURED EXTRA CARE INC
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 5540 CENTERVIEW DR STE 200
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City | RALEIGH
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State | NC
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Zip | 27606-3386
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Country | US
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Telephone | 832-794-5177
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Fax |
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Provider Business Mailing Address
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Address Line | 12203 RESIDENT CIR # 12203
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City | CARY
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State | NC
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Zip | 27519-9467
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Country | US
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Telephone | 832-794-5177
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | OMOYEMI A FASHEUN
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Credential | CEO
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Telephone | 832-794-5177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 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 #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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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 | 224ZF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapy Assistant
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 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 #10
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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 #11
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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 #12
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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