Extended Life Personal Care Staffing Agency,LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

EXTENDED LIFE PERSONAL CARE STAFFING AGENCY,LLC

Practice address

310 Mid Continent PLZ Ste 460
West Memphis, AR 72301-1700

Phone

(501) 316-7839

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

Colesha Cannady

Title

Owner

Phone

(501) 316-7839

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1962962761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MID CONTINENT PLZ STE 460",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011700",
            "telephone_number": "501-316-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MID CONTINENT PLZ STE 460",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723011700",
            "telephone_number": "501-316-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED LIFE PERSONAL CARE STAFFING AGENCY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "CANNADY",
        "authorized_official_first_name": "COLESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-316-7839"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale Engelberg, MA
• Lawanda English
• Stacia Latorria Evans, BCBA
• Jacob Kannan Everhart, DDS
• Evolve Counseling & Consultation
• Tommy Lee Fair, CRNA
• Family Cancer Center, PLLC
• Amber Faulkner
• Kolesha Felton
• Fenter Physical Therapy

• Home Health Aide in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Home Health Aide in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.

Verify at the official NPI Registry.