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General NPI Number Information
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NPI Number | 1871453183
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Entity Type | Organization
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Legal Business Name | EXTENDED FAMILY FOREVER LLC
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 441 CLARK STREET 1/2
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City | CAMBRIDGE
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State | OH
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Zip | 43725
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Country | US
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Telephone | 614-381-1084
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Fax |
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Provider Business Mailing Address
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Address Line | 441 CLARK STREET 1/2
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City | CAMBRIDGE
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State | OH
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Zip | 43725
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PARIS HAYES
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Credential | PCA
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Telephone | 614-381-1084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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