Extreme Care Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EXTREME CARE SERVICES LLC

Practice address

5604 Town N Country Blvd
Tampa, FL 33615-4142

Phone

(813) 731-3250

Fax

(313) 731-3252

NPI assigned

Oct 14, 2008

Last updated

Sep 9, 2013By 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

Ms. Evelyn Amanda Rosario Jackson

Title

MGR

Phone

(813) 731-3250

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1881846418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 TOWN N COUNTRY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154142",
            "telephone_number": "813-731-3250",
            "fax_number": "313-731-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 TOWN N COUNTRY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154142",
            "telephone_number": "813-731-3250",
            "fax_number": "313-731-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTREME CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "ROSARIO JACKSON",
        "authorized_official_first_name": "EVELYN AMANDA",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "813-731-3250",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA NUMBER",
            "identifier": "39965537",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.