# EXTENDED FAMILY INC

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

## Provider details

- **NPI number:** 1255582946
- **Authorized official:** DEBRICA JOLIVETTE (DIRECTOR/OWNER)
- **Authorized official phone:** (337) 280-2621

## Contact information

- **Practice address:** 201 LEONARD ST, BREAUX BRIDGE, LA 70517-5199
- **Practice address phone:** (337) 507-3819
- **Practice address fax:** (337) 332-0072
- **Mailing address:** 201 LEONARD ST, BREAUX BRIDGE, LA 70517-5199
- **Mailing address phone:** (337) 507-3819
- **Mailing address fax:** (337) 332-0072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | PCA 15114 | LA | Yes |

## Other

- **Enumeration date:** 10/01/2008
- **Last updated:** 10/01/2008