Extended Quality of Life, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1000000018653 Issued in TN

Legal business name

EXTENDED QUALITY OF LIFE, LLC

Practice address

2677 Wigan CV
Cordova, TN 38016-0115

Phone

(901) 315-7652

NPI assigned

Oct 13, 2016

Last updated

Oct 13, 2016By 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

Antonisha Adair, MSW,LSSW

Title

Owner

Phone

(901) 315-7652

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1891245890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 WIGAN CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160115",
            "telephone_number": "901-315-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 WIGAN CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160115",
            "telephone_number": "901-315-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED QUALITY OF LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "ADAIR",
        "authorized_official_first_name": "ANTONISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-315-7652",
        "authorized_official_credential": "MSW,LSSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "1000000018653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherwonna K. Evans, MA, CCC-SLP
• Neil Mark Everingham, AUDIOLOGIST
• Exceptional Development Family Treatment Center, LLC
• Exploratory Centers of America, LLC
• Exploratory Centers of America, LLC
• Eye Care Associates of Co, LLC
• Eyemart Express LTD (EyeMart Express)
• Allegra Vanessa McDonald Fadeyi, PHARMD, CGP
• Oluwatosin A Fadeyi, PHARMD/MBA
• Lisa Diane Fair, PMHNP-BC

• Home Health Agency in Cordova, TN
• Providers in Cordova, TN by specialty
• Home Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.