| Extended Family Care Llc | |
|
1001 Mcarthur St Manchester TN 37355-2419 | |
| (931) 295-0856 | |
| (931) 954-0856 |
| Full Name | Extended Family Care Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1001 Mcarthur St, Manchester, Tennessee |
| Authorized Official Name and Position | Rose L Dodge (ADMINSTRATOR/OWNER) |
| Authorized Official Contact | 3199523499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Extended Family Care Llc Po Box 870 Manchester TN 37349-0870 Ph: (931) 295-6252 | Extended Family Care Llc 1001 Mcarthur St Manchester TN 37355-2419 Ph: (931) 295-0856 |
| NPI Number | 1225659956 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 05/15/2020 |
| Certification Date | 05/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225659956 | NPI | - | NPPES |
| H445690 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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