Provider Demographics
NPI:1992047096
Name:EXTENDED CARE INC.
Entity type:Organization
Organization Name:EXTENDED CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXEC.DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERLYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS-GLEATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-849-0270
Mailing Address - Street 1:5282 STATION CIR
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-4501
Mailing Address - Country:US
Mailing Address - Phone:770-849-0270
Mailing Address - Fax:770-849-0279
Practice Address - Street 1:5282 STATION CIR
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4501
Practice Address - Country:US
Practice Address - Phone:770-849-0270
Practice Address - Fax:770-849-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle