Provider Demographics
NPI:1306357322
Name:EXTENDED HOME CARE CO.
Entity Type:Organization
Organization Name:EXTENDED HOME CARE CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-751-3363
Mailing Address - Street 1:109 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-3104
Mailing Address - Country:US
Mailing Address - Phone:701-751-3363
Mailing Address - Fax:701-751-1163
Practice Address - Street 1:109 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-3104
Practice Address - Country:US
Practice Address - Phone:701-751-3363
Practice Address - Fax:701-751-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty