Provider Demographics
NPI:1093586745
Name:EXTENDED HANDS LLC HOME CARE AGENCY
Entity Type:Organization
Organization Name:EXTENDED HANDS LLC HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:CALA
Authorized Official - Phone:848-299-1396
Mailing Address - Street 1:155 ATLANTIC CITY BLVD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1285
Mailing Address - Country:US
Mailing Address - Phone:551-733-6078
Mailing Address - Fax:732-569-3136
Practice Address - Street 1:155 ATLANTIC CITY BLVD UNIT 5
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1285
Practice Address - Country:US
Practice Address - Phone:848-299-1396
Practice Address - Fax:732-569-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care