Provider Demographics
NPI:1083080287
Name:EXTRA HELP HEALTH CARE, LLC
Entity Type:Organization
Organization Name:EXTRA HELP HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR BUSINESS
Authorized Official - Phone:501-366-3585
Mailing Address - Street 1:16 MARCHWOOD CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-3704
Mailing Address - Country:US
Mailing Address - Phone:501-366-3585
Mailing Address - Fax:501-414-8092
Practice Address - Street 1:16 MARCHWOOD CV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-3704
Practice Address - Country:US
Practice Address - Phone:501-366-3585
Practice Address - Fax:501-414-8092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR032359251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health