Provider Demographics
NPI:1023394996
Name:EXTENDED CARE NURSING SERVICES
Entity Type:Organization
Organization Name:EXTENDED CARE NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-737-4844
Mailing Address - Street 1:1903 S CONGRESS AVE
Mailing Address - Street 2:#380
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6548
Mailing Address - Country:US
Mailing Address - Phone:561-737-4844
Mailing Address - Fax:561-737-4854
Practice Address - Street 1:1903 S CONGRESS AVE
Practice Address - Street 2:#380
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6548
Practice Address - Country:US
Practice Address - Phone:561-737-4844
Practice Address - Fax:561-737-4854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211497251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care