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General NPI Number Information
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NPI Number | 1134528649
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Entity Type | Organization
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Legal Business Name | EXTRA HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 5413 NAAMAN FOREST BLVD 837
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City | GARLAND
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State | TX
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Zip | 75044-5624
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Country | US
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Telephone | 214-384-2949
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Fax |
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Provider Business Mailing Address
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Address Line | 5413 NAAMAN FOREST BLVD 837
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City | GARLAND
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State | TX
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Zip | 75044-5624
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Country | US
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Telephone | 214-384-2949
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | NICHOLAS CHINONSO ATUMAH
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Credential | RN, BSN
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Telephone | 214-384-2949
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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 | TX
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