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General NPI Number Information
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NPI Number | 1609446798
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Entity Type | Organization
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Legal Business Name | EXTRA CARE FOR THE PALM BEACHES LLC
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 1499 FOREST HILL BLVD STE 117
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6050
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Country | US
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Telephone | 561-870-3312
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Fax |
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Provider Business Mailing Address
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Address Line | 1499 FOREST HILL BLVD STE 117
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-6050
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Country | US
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Telephone | 561-870-3312
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ALT ADMIN/CFO
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Name | GERALDA BROWN
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Credential |
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Telephone | 561-302-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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