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EXTENDED HOME CARE TN INC NPI 1376814806


NPI Information

NPI: 1376814806
Provider Name: EXTENDED HOME CARE TN, INC

Doing Business As: ADVANTAGE HOME CARE

Classification: In Home Supportive Care - 253Z00000X
Entity Type: Organization

CLIA Number: 44D2044225

Address:
3175 LENOX PARK BLVD STE 104
MEMPHIS, TN
ZIP 38115
Phone: (901) 881-0645
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EXTENDED HOME CARE TN, INC is an in home supportive care in Memphis, TN. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. EXTENDED HOME CARE TN, INC NPI is 1376814806. The provider is registered as an organization entity type.
The provider Is Doing Business As Advantage Home Care.

The provider's business location address is:

3175 LENOX PARK BLVD STE 104
MEMPHIS, TN
ZIP 38115-399
Phone: (901) 881-0645
Fax: (901) 881-0647

The provider's authorized official is Debra M. Clark .
The authorized official title is Managing Dir/board Vice Chairman and has the following contact phone number (901) 881-0645.

The CLIA number assigned to this NPI record is 44D2044225 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2012 and was last updated on 8/25/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1253Z00000XIn Home Supportive CareTENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10445765MEDICAIDTENNESSEE
2H445629MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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