Organization
EXTENDED FAMILY CARE LLC
Active
Parent organization
EXTENDED FAMILY CARE, LLC
Other names
Legends, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EXTENDED FAMILY CARE, LLC
Authorized official
MRS. ROSE L DODGE (ADMINSTRATOR/OWNER)
(319) 952-3499
Entity
Organization
Contact information
Practice address
1001 MCARTHUR ST, MANCHESTER, TN 37355-2419
(931) 295-0856
(931) 954-0856
Mailing address
PO BOX 870, MANCHESTER, TN 37349-0870
(931) 295-6252
(931) 954-0856
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445690
—
TN
Enumeration date
05/05/2020
Last updated
05/15/2020
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