# EXTENDED CARE SERVICES

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

## Provider details

- **NPI number:** 1912541400
- **Authorized official:** PAULA NASH CNA (DIRECTOR)
- **Authorized official phone:** (262) 353-1910

## Contact information

- **Practice address:** N112W16298 MEQUON RD \# 142, GERMANTOWN, WI 53022-3306
- **Practice address phone:** (262) 353-1910
- **Mailing address:** N112W16298 MEQUON RD \# 142, GERMANTOWN, WI 53022-3306
- **Mailing address phone:** (262) 353-1910

## Taxonomy

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

## Other

- **Enumeration date:** 10/29/2019
- **Last updated:** 10/29/2019