Organization
XTENDED HANDS HOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORNA RENEE JACKSON CNA (OWNER)
(623) 387-0770
Entity
Organization
Contact information
Practice address
1725 W GLENDALE AVE APT 2091, PHOENIX, AZ 85021-8809
(623) 387-0770
Mailing address
1725 W GLENDALE AVE APT 2091, PHOENIX, AZ 85021-8809
(623) 387-0770
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
04/16/2021
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