# EXTENSION HOME CARE LLC

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

## Provider details

- **NPI number:** 1841662616
- **Authorized official:** CATHLEEN MERRITT (VICE PRESIDENT)
- **Authorized official phone:** (904) 484-8360

## Contact information

- **Practice address:** 2132 GAMMA CT, ORANGE PARK, FL 32073-5110
- **Practice address phone:** (904) 494-8360
- **Mailing address:** 419A COLLEGE DR, SUITE 1, MIDDLEBURG, FL 32068-6508

## Taxonomy

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

## Other

- **Enumeration date:** 10/20/2015
- **Last updated:** 10/20/2015