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General NPI Number Information
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NPI Number | 1457644825
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Entity Type | Organization
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Legal Business Name | EXTENDED CARE SERVICES
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 15 PINEWOOD LN
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City | PARKERSBURG
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State | WV
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Zip | 26104-8141
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Country | US
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Telephone | 304-424-5005
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Fax | 304-865-3309
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Provider Business Mailing Address
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Address Line | 15 PINEWOOD LN
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City | PARKERSBURG
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State | WV
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Zip | 26104-8141
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Country | US
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Telephone | 304-424-5005
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Fax | 304-865-3309
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT WILLIAM CHRISTIE
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Credential |
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Telephone | 304-424-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 1009-8957
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License Number State | WV
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