Provider Demographics
NPI:1659381135
Name:EXTRA CARE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:EXTRA CARE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:EYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:813-205-8536
Mailing Address - Street 1:7005 PELICAN ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-7422
Mailing Address - Country:US
Mailing Address - Phone:813-205-8536
Mailing Address - Fax:813-882-3589
Practice Address - Street 1:9002 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3717
Practice Address - Country:US
Practice Address - Phone:813-901-0236
Practice Address - Fax:813-901-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG06074900030251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health