Provider Demographics
NPI:1407455462
Name:EXTENDING A HAND HOME CARE
Entity Type:Organization
Organization Name:EXTENDING A HAND HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-825-1687
Mailing Address - Street 1:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:TENNILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31089-0301
Mailing Address - Country:US
Mailing Address - Phone:888-552-7874
Mailing Address - Fax:888-491-7373
Practice Address - Street 1:207 MILL LN
Practice Address - Street 2:
Practice Address - City:TENNILLE
Practice Address - State:GA
Practice Address - Zip Code:31089-4308
Practice Address - Country:US
Practice Address - Phone:888-552-7874
Practice Address - Fax:888-491-7373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies