Active NPI
Xtreme Personal Care Services LLC
- Home Health Agency
- East Orange, NJ
National Provider Identifier
1821632415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- XTREME PERSONAL CARE SERVICES LLC
- Practice address
- 16 Lake St
East Orange, NJ 07017-1704 - Phone
- (862) 285-6295
- NPI assigned
- Nov 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samiyyah M Gibson
- Title
- Owner
- Phone
- (862) 285-6295
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
16 Lake St
East Orange, NJ 07017-1704
Mailing address
16 Lake St
East Orange, NJ 07017-1704
Phone (862) 285-6295
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1572998400000",
"number": "1821632415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 LAKE ST",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070171704",
"telephone_number": "862-285-6295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 LAKE ST",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070171704",
"telephone_number": "862-285-6295"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "XTREME PERSONAL CARE SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-06",
"last_updated": "2019-11-06",
"status": "A",
"authorized_official_last_name": "GIBSON",
"authorized_official_first_name": "SAMIYYAH",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "862-285-6295"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.