Provider Demographics
NPI:1952761900
Name:EXTENDED HAND HOME CARE
Entity type:Organization
Organization Name:EXTENDED HAND HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MYRLANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLON
Authorized Official - Suffix:I
Authorized Official - Credentials:CNA
Authorized Official - Phone:646-667-7405
Mailing Address - Street 1:11341 FARMERS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2425
Mailing Address - Country:US
Mailing Address - Phone:646-667-7405
Mailing Address - Fax:
Practice Address - Street 1:11341 FARMERS BLVD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2425
Practice Address - Country:US
Practice Address - Phone:646-667-7405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341840340702E251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health