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Organization
EXTENSION HOME HEALTH SERVICES LLC
Active
Organization
EXTENSION HOME HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANEKA M WALKER NURSE PRACTITIONER (OWNER)
(937) 522-1763
Entity
Organization
Contact information
Practice address
5101 CRESTWATER DR, MANSFIELD, TX 76063-6842
(937) 522-1763
Mailing address
PO BOX 1441, MANSFIELD, TX 76063-1441
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
385H00000X
Respite Care
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851654271
UNKNOWN
TX
Enumeration date
07/01/2014
Last updated
07/01/2014
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