Provider Demographics
NPI:1366084865
Name:EXTREME HOME CARE SERVICES, INC.
Entity type:Organization
Organization Name:EXTREME HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADEOLA
Authorized Official - Middle Name:TEMITOPE
Authorized Official - Last Name:SOTUBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-240-5581
Mailing Address - Street 1:11886 NEW COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4406
Mailing Address - Country:US
Mailing Address - Phone:667-240-5881
Mailing Address - Fax:
Practice Address - Street 1:11886 NEW COUNTRY LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-4406
Practice Address - Country:US
Practice Address - Phone:667-240-5881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty