Organization
EXTRA HANDS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY YVONNE SMITH (OWNER PRESIDENT)
(573) 334-5333
Entity
Organization
Contact information
Practice address
937 BROADWAY, SUITE 103, CAPE GIRARDEAU, MO 63701-5474
(573) 334-5333
(573) 334-4031
Mailing address
937 BROADWAY, SUITE 103, CAPE GIRARDEAU, MO 63701-5474
(573) 334-5333
(573) 334-4031
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
3176 7622
MO
376J00000X
Homemaker
DA8020
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265249904
DOA
MO
01
—
285249900
DOA
MO
05
—
855249900
—
MO
Enumeration date
03/21/2007
Last updated
06/13/2008
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