Provider Demographics
NPI:1417298282
Name:XTRA PAIR OF HANDS, LLC
Entity Type:Organization
Organization Name:XTRA PAIR OF HANDS, LLC
Other - Org Name:XTRA PAIR OF HANDS SENIOR CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KYM
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-825-4398
Mailing Address - Street 1:2004 EASTVIEW PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-5770
Mailing Address - Country:US
Mailing Address - Phone:404-855-4592
Mailing Address - Fax:
Practice Address - Street 1:2004 EASTVIEW PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-5770
Practice Address - Country:US
Practice Address - Phone:404-825-4398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health