Provider Demographics
NPI:1760023501
Name:EXTENDED FAMILY HOME CARE SERVICES
Entity Type:Organization
Organization Name:EXTENDED FAMILY HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAI-RENAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-608-9048
Mailing Address - Street 1:301 N GUM ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6861
Mailing Address - Country:US
Mailing Address - Phone:843-608-9048
Mailing Address - Fax:
Practice Address - Street 1:3800 RIVERS AVE STE A
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7067
Practice Address - Country:US
Practice Address - Phone:843-608-9048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No385H00000XRespite Care FacilityRespite Care