| Organization Name: | EXTENDED HEALTH SERVICES, INC |
| NPI Number: | 1093084519 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENDA HARRIS (ADMINISTRATOR) |
| Mailing Address: | 2733 Sheraton Dr Bldg. F-165 Macon |
| State: | GA US |
| Postal Code: | 312046826 |
| Phone Number: | 4787469988 |
| Fax Number: | 4787465111 |
| NPI Enumeration Date: | 12/29/2011 |
| NPI Last Update Date: | 12/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 011-R-0034 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |