Provider Demographics
NPI:1760345789
Name:XTRAMILES HOME HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:XTRAMILES HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:ONOME
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-740-4732
Mailing Address - Street 1:1604 W GALVESTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8315
Mailing Address - Country:US
Mailing Address - Phone:918-740-4732
Mailing Address - Fax:
Practice Address - Street 1:2488 E 81ST ST STE 4807
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4290
Practice Address - Country:US
Practice Address - Phone:918-740-4732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health