# EXTENDED CARE &SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083416721
- **Authorized official:** DISHANNA HAWKINS (ADMINISTRATOR)
- **Authorized official phone:** (216) 324-5593

## Contact information

- **Practice address:** 840 BENTLEY DR, PRINCE FREDERICK, MD 20678-3572
- **Practice address phone:** (216) 324-5593
- **Mailing address:** 840 BENTLEY DR, PRINCE FREDERICK, MD 20678-3572
- **Mailing address phone:** (216) 324-5593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/25/2025
- **Last updated:** 03/25/2025