Extended Care of the Triad LLC

Primary specialty

Adult CompanionTaxonomy code 372600000X

Legal business name

EXTENDED CARE OF THE TRIAD LLC

Practice address

313 Trindale Rd # a
Ste 203
Archdale, NC 27263-3800

Phone

(336) 861-6826

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kim Lea Bass, CNA

Title

Owner President

Phone

(336) 687-9220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861518334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 A TRINDALE RD",
            "address_2": "STE 203",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "27263",
            "telephone_number": "336-861-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 TRINDALE RD # A",
            "address_2": "STE 203",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633800",
            "telephone_number": "336-861-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE OF THE TRIAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "336-687-9220",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John David Ellington
• Eric Tobias Helms (Carolina Sleep Center)
• Richard Timothy Escajeda, MD
• Debbie Milan Esque, LPC
• Mitchell N Evans, OD
• Hubert L Fiery, MD
• Five Angels Care
• Focus Physical Therapy
• Laura Fritts, PHARMD
• Cathy A Fulp, O.D.

• Adult Companion in Archdale, NC
• Providers in Archdale, NC by specialty
• Adult Companion in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.