MEDICARE: ESSENTIAL LIVING HOME HEALTH CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1205083037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL LIVING HOME HEALTH CARE INC.

Provider Business Mailing Address
First Line	:	5915 ABBINGTON WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-6583
Country	:	US
Telephone Number	:	919-824-5991
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 ABBINGTON WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-6583
Country	:	US
Telephone Number	:	919-824-5991
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LESA KAY WILLIAMS
Credential	:
Telephone Number	:	919-824-5991

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	08/22/2008

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