Provider Demographics
NPI:1841079100
Name:EXTENDED FAMILY CARE LLC
Entity type:Organization
Organization Name:EXTENDED FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR IN-HOME CARE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAULO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-344-3430
Mailing Address - Street 1:1671 E MONTE VISTA AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3126
Mailing Address - Country:US
Mailing Address - Phone:707-317-1282
Mailing Address - Fax:707-632-4297
Practice Address - Street 1:1671 E MONTE VISTA AVE STE 211
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3126
Practice Address - Country:US
Practice Address - Phone:707-317-1282
Practice Address - Fax:707-632-4297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care