Extraordinary Holdings Corp.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EXTRAORDINARY HOLDINGS CORP.

Doing business as

Senior Helpers Seal Beach-Los Alamitos CA

Practice address

4501 Cerritos Ave Ste 203
Cypress, CA 90630-4215

Phone

(562) 900-7845

NPI assigned

Apr 21, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Steven Duane Nickens Sr.

Title

Ceo

Phone

(562) 900-7845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Senior Helpers Seal Beach-Los Alamitos CA Doing business as

Locations

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1417539370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 CERRITOS AVE STE 203",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304215",
            "telephone_number": "714-816-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 CERRITOS AVE STE 203",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304215",
            "telephone_number": "562-900-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRAORDINARY HOLDINGS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "NICKENS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-900-7845",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CARE ORGANIZATION LICENSE NUMBER",
            "identifier": "194700756",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Helpers Seal Beach-Los Alamitos CA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Senior Helpers Seal Beach-Los Alamitos CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Cypress, CA
• Providers in Cypress, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.