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NPI 1265347546

NPI 1265347546 : EXTREME CARE SERVICES LLC : GREENVILLE, NC

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General NPI Number Information
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    NPI Number           |    1265347546
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    Entity Type          |    Organization 
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    Legal Business Name  |    EXTREME CARE SERVICES LLC 
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Dates
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    Enumeration Date     |    08/19/2026
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    Last Update Date     |    08/22/2026
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Provider Practice Location Address
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    Address Line         |    1807 KENNEDY CIR 
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    City                 |    GREENVILLE
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    State                |    NC
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    Zip                  |    27834-5223
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    Country              |    US
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    Telephone            |    252-802-1169
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1807 KENNEDY CIR 
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    City                 |    GREENVILLE
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    State                |    NC
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    Zip                  |    27834-5223
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    Country              |    US
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    Telephone            |    252-802-1169
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. MALCOLM  BLOUNT 
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    Credential           |    HOME HEALTH
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    Telephone            |    252-802-1169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral 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        |    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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