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General NPI Number Information
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NPI Number | 1548080922
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Entity Type | Organization
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Legal Business Name | XTENDED ARMS
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 1111 WEBSTER ST
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City | FAIRFIELD
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State | CA
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Zip | 94533-4841
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Country | US
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Telephone | 510-362-9116
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1328
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City | SUISUN CITY
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State | CA
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Zip | 94585-4328
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Country | US
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Telephone | 510-362-9116
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLEE ESPADRON
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Credential |
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Telephone | 510-362-9116
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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 |
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