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General NPI Number Information
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NPI Number | 1508866930
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Entity Type | Organization
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Legal Business Name | EXTENDED FAMILY ENTERPRISES, INC
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 2710 PHILLIPS DR
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City | JONESBORO
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State | AR
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Zip | 72401-7332
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Country | US
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Telephone | 870-932-7463
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Fax | 870-932-0478
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Provider Business Mailing Address
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Address Line | 2710 PHILLIPS DR
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City | JONESBORO
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State | AR
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Zip | 72401-7332
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Country | US
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Telephone | 870-932-7463
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Fax | 870-932-0478
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JANA K WRIGHT
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Credential | LPN
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Telephone | 870-932-7463
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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 | AR4224
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License Number State | AR
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