Provider Demographics
NPI:1467293548
Name:EXTENDED KIDS CARE, INC.
Entity type:Organization
Organization Name:EXTENDED KIDS CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:786-603-9377
Mailing Address - Street 1:3000 NW 101ST LN UNIT 101
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3930
Mailing Address - Country:US
Mailing Address - Phone:786-603-9377
Mailing Address - Fax:
Practice Address - Street 1:3000 NW 101ST LN UNIT 101
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3930
Practice Address - Country:US
Practice Address - Phone:754-241-5305
Practice Address - Fax:754-241-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric