Organization
EXTRAORDINARY HOLDINGS CORP.
Active
Other names
Senior Helpers Seal Beach-Los Alamitos CA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN DUANE NICKENS SR. (CEO)
(562) 900-7845
Entity
Organization
Contact information
Practice address
4501 CERRITOS AVE STE 203, CYPRESS, CA 90630-4215
(562) 900-7845
Mailing address
4501 CERRITOS AVE STE 203, CYPRESS, CA 90630-4215
(714) 816-5069
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194700756
HEALTH CARE ORGANIZATION LICENSE NUMBER
CA
Enumeration date
04/21/2021
Last updated
11/25/2024
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