Extended Home Care, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EXTENDED HOME CARE, INC.

Practice address

105 Russell St
Hayti, MO 63851-1300

Phone

(573) 359-2930

Fax

(573) 359-1304

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Debra M Clark, RN

Title

Ceo/Secretary of the Board

Phone

(573) 359-5546

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Extended Home Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Extended Home Care, Inc

  • In Home Supportive Care Agency
  • Hayti, MO
  • NPI 1871611814
  NPD tax ID

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636675200000",
    "number": "1861474900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RUSSELL ST",
            "address_2": "PO BOX 393",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638511300",
            "telephone_number": "573-359-2930",
            "fax_number": "573-359-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RUSSELL ST",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638511300",
            "telephone_number": "573-359-2930",
            "fax_number": "573-359-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/SECRETARY OF THE BOARD",
        "authorized_official_telephone_number": "573-359-5546",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSBG",
            "identifier": "0003454",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268892502",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisha J Evans
• Extended Enterprises, Inc
• Extended Family Home Health, Inc.
• Extended Health Services, Inc.
• Extended Home Care, Inc
• Extended Medical, Inc
• Vicky Lynne Fairey, RN,C
• Family Counseling Center
• Family Counseling Center, Inc.
• Family Counseling Center, Inc.

• All providers in Hayti, MO
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.