Provider Demographics
NPI:1346573573
Name:EXTENDING HANDS UNLIMITED
Entity Type:Organization
Organization Name:EXTENDING HANDS UNLIMITED
Other - Org Name:EXTENDING HANDS IN HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-547-1826
Mailing Address - Street 1:4342 ATLANTIC AVENUE SUITE B
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807
Mailing Address - Country:US
Mailing Address - Phone:562-424-2114
Mailing Address - Fax:562-424-2116
Practice Address - Street 1:4342 ATLANTIC AVENUE SUITE B
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:562-424-2114
Practice Address - Fax:565-424-2116
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXTENDING HANDS UNLIMITED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABU20902610364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Single Specialty