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General NPI Number Information
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NPI Number | 1831047570
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Entity Type | Organization
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Legal Business Name | EXTENTION OF LIFE CARE, LLC
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 7850 COMMONS PARK CIR NW # 427
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City | CONCORD
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State | NC
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Zip | 28027-4423
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Country | US
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Telephone | 704-517-4631
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Fax |
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Provider Business Mailing Address
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Address Line | 7850 COMMONS PARK CIR NW # 427
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City | CONCORD
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State | NC
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Zip | 28027-4423
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Country | US
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Telephone | 704-517-4631
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAYVETTE PAYNE
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Credential | CMA,CNA,PHLEBOTOMIST
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Telephone | 704-517-4631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #7
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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 #8
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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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Taxonomy #9
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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