Provider Demographics
NPI:1073146981
Name:EXTRAORDINARY SERVICES LLC
Entity Type:Organization
Organization Name:EXTRAORDINARY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:MAYE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-757-6698
Mailing Address - Street 1:231 BARNWELL AVE NW STE D
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3903
Mailing Address - Country:US
Mailing Address - Phone:803-226-0420
Mailing Address - Fax:803-226-0377
Practice Address - Street 1:231 BARNWELL AVE NW STE D
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3903
Practice Address - Country:US
Practice Address - Phone:803-226-0420
Practice Address - Fax:803-226-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health