Organization
EXTENDED LIFE PERSONAL CARE STAFFING AGENCY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLESHA CANNADY (OWNER)
(501) 316-7839
Entity
Organization
Contact information
Practice address
310 MID CONTINENT PLZ STE 460, WEST MEMPHIS, AR 72301-1700
(501) 316-7839
Mailing address
310 MID CONTINENT PLZ STE 460, WEST MEMPHIS, AR 72301-1700
(501) 316-7839
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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