Extended Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EXTENDED CARE LLC

Practice address

5423 Harrison St
Hollywood, FL 33021-6406

Phone

(954) 967-8428

Fax

(954) 589-5230

NPI assigned

Nov 20, 2020

Organization subpart

No

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

Authorized official

Name

Courtney Earle

Title

Administrator

Phone

(954) 275-3446

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1134722101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5423 HARRISON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216406",
            "telephone_number": "954-967-8428",
            "fax_number": "954-589-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5423 HARRISON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216406",
            "telephone_number": "954-967-8428",
            "fax_number": "954-589-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "EARLE",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-275-3446"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.