Provider Demographics
NPI:1033677299
Name:FAMILY EXTENSIONS HOME HEALTH
Entity Type:Organization
Organization Name:FAMILY EXTENSIONS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TELFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CAREGIVER
Authorized Official - Phone:520-339-0783
Mailing Address - Street 1:3225 S WILMOT RD APT 7125
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-2281
Mailing Address - Country:US
Mailing Address - Phone:520-339-0783
Mailing Address - Fax:
Practice Address - Street 1:3225 S WILMOT RD APT 7125
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-2281
Practice Address - Country:US
Practice Address - Phone:520-339-0783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY EXTENSIONS HOME HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZNAOtherNA