Provider Demographics
NPI:1922883420
Name:EXTENDED FAMILY HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:EXTENDED FAMILY HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, OWNER, DON, RN, MSN
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:937-768-1556
Mailing Address - Street 1:989 S SOUTH ST STE B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2921
Mailing Address - Country:US
Mailing Address - Phone:937-768-1556
Mailing Address - Fax:937-915-2060
Practice Address - Street 1:989 S SOUTH ST STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2921
Practice Address - Country:US
Practice Address - Phone:937-768-1556
Practice Address - Fax:937-915-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health