Organization
EXTENDED OPTIMUM MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TAWANA LAE GRACE (OWNER)
(908) 644-2650
Entity
Organization
Contact information
Practice address
1130 ROUTE 202, SUITE #6 BLDG E, RARITAN, NJ 08869-1490
(908) 644-2650
Mailing address
30 WORLDS FAIR DR, SUITE110, SOMERSET, NJ 08873-1346
(908) 644-2650
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/27/2010
Last updated
02/25/2010
About Stedi
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