Provider Demographics
NPI:1235431545
Name:EXTENDED HANDS LIFECARE LLC
Entity Type:Organization
Organization Name:EXTENDED HANDS LIFECARE LLC
Other - Org Name:BRIGHTSTAR OF EAST SEMINOLE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:KISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-278-4570
Mailing Address - Street 1:800 WESTWOOD SQ
Mailing Address - Street 2:SUITE E
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8849
Mailing Address - Country:US
Mailing Address - Phone:407-278-4570
Mailing Address - Fax:321-348-9515
Practice Address - Street 1:800 WESTWOOD SQ
Practice Address - Street 2:SUITE E
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8849
Practice Address - Country:US
Practice Address - Phone:407-278-4570
Practice Address - Fax:321-348-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health