Provider Demographics
NPI:1396044178
Name:EXTRA CARE HOME HEALTH
Entity Type:Organization
Organization Name:EXTRA CARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DURDANA
Authorized Official - Middle Name:SHER
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-915-8333
Mailing Address - Street 1:315 N 3RD AVE
Mailing Address - Street 2:STE 300A
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1905
Mailing Address - Country:US
Mailing Address - Phone:626-915-8333
Mailing Address - Fax:626-915-8350
Practice Address - Street 1:315 N 3RD AVE
Practice Address - Street 2:STE 300A
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1905
Practice Address - Country:US
Practice Address - Phone:626-915-8333
Practice Address - Fax:626-915-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health