Provider Demographics
NPI:1861795262
Name:EXTENDED LIFE HOME CARE LTD
Entity type:Organization
Organization Name:EXTENDED LIFE HOME CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-476-4400
Mailing Address - Street 1:1350 W 5TH AVE STE 16
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2907
Mailing Address - Country:US
Mailing Address - Phone:614-476-4400
Mailing Address - Fax:
Practice Address - Street 1:1250 CHAMBERS RD STE 230
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1755
Practice Address - Country:US
Practice Address - Phone:614-476-4400
Practice Address - Fax:614-489-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health