Extended Grace Home Care Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXTENDED GRACE HOME CARE SERVICES LLC

Practice address

1905 N Ridge Rd E Ste D
Lorain, OH 44055-3344

Phone

(440) 412-9279

Fax

(440) 848-8894

NPI assigned

Dec 16, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yalesia N CooperNPI 1891264909

Title

Owner

Phone

(440) 453-8981

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yalesia Nicole Cooper, LPN

  • Nurse's Aide
  • North Ridgeville, OH
  • NPI 1891264909
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1104397397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5918 OLIVE AVE",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440391832",
            "telephone_number": "440-412-9279",
            "fax_number": "440-848-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 N RIDGE RD E STE D",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440553344",
            "telephone_number": "440-412-9279",
            "fax_number": "440-848-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED GRACE HOME CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "YALESIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-453-8981"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0275647",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Evans
• Jeremy Evenden, L.I.S.W.
• Jeanette Everard
• Lisa Everett, RN
• Lydia Everly, LPCC
• Extendicare Homes, Inc.
• F.E. Yuzon, M.D. Inc
• F.E.Yuzon, M.D. Inc.
• Nikita Marie Faddis
• Sheema M Fairley

• Home Health Agency in Lorain, OH
• Providers in Lorain, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.