Organization
XTREME PERSONAL CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIYYAH M GIBSON (OWNER)
(862) 285-6295
Entity
Organization
Contact information
Practice address
16 LAKE ST, EAST ORANGE, NJ 07017-1704
(862) 285-6295
Mailing address
16 LAKE ST, EAST ORANGE, NJ 07017-1704
(862) 285-6295
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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