Organization
EXTRA HAND IN-HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY ELLIS GAINES (PRESIDENT/ MANAGING MEMBER)
(909) 360-2223
Entity
Organization
Contact information
Practice address
8439 WHITE OAK AVE STE 104, RANCHO CUCAMONGA, CA 91730-3860
(909) 360-2223
(909) 360-2293
Mailing address
8439 WHITE OAK AVE STE 104, RANCHO CUCAMONGA, CA 91730-3860
(909) 360-2223
(909) 360-2293
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
364700044
CA
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
385HR2050X
Respite Care Camp
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080126397
DUN & BRADSTREET
—
01
—
364700044
CALIFORNIA DEPTARTMENT OF SOCIAL SERVICES
CA
01
—
550007839
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CA
Enumeration date
06/23/2017
Last updated
02/01/2023
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