Provider Demographics
NPI:1467133702
Name:XTENSION OF CARE SERVICES LLC
Entity Type:Organization
Organization Name:XTENSION OF CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE-COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-242-6447
Mailing Address - Street 1:12200 FAIRHILL RD STE B221
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1058
Mailing Address - Country:US
Mailing Address - Phone:216-242-6447
Mailing Address - Fax:216-232-6274
Practice Address - Street 1:934 PEMBROOK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44121-1402
Practice Address - Country:US
Practice Address - Phone:216-760-9591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health