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Organization
XTRAORDINARY CARE
Active
Organization
XTRAORDINARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLARISSA JOHNNIE (LVN)
(409) 433-7433
Entity
Organization
Contact information
Practice address
1310 IH 10 S STE 210, BEAUMONT, TX 77707-4444
(409) 433-7433
Mailing address
3910 TREADWAY RD APT 803, BEAUMONT, TX 77706-7137
(409) 433-7433
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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