Provider Demographics
NPI:1992503239
Name:EXTENDED FAMILY HOMECARE
Entity type:Organization
Organization Name:EXTENDED FAMILY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LAQUASHA
Authorized Official - Middle Name:DUSHEA
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-558-6909
Mailing Address - Street 1:236 SOUTHERLY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2336
Mailing Address - Country:US
Mailing Address - Phone:937-558-6909
Mailing Address - Fax:
Practice Address - Street 1:236 SOUTHERLY HILLS DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2336
Practice Address - Country:US
Practice Address - Phone:937-558-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty