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NPI Code Detail

MEDICARE: ESIESON HEALTH CARE GROUP LLC

MEDICARE: ESIESON HEALTH CARE GROUP LLC
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1245098128
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESIESON HEALTH CARE GROUP LLC
Provider Business Mailing Address
First Line : 6520 POE AVE STE 170R4
Second Line :
City : DAYTON
State : OH
Zip : 45414-2792
Country : US
Telephone Number : 937-387-9209
Fax Number :
Provider Business Practice Location Address
First Line : 6520 POE AVE STE 170R4
Second Line :
City : DAYTON
State : OH
Zip : 45414-2792
Country : US
Telephone Number : 937-212-9834
Fax Number :
Authorized Official
Title or Position : CEO
Name : MRS. SUSIE E DIBO-NGALLE
Credential : BSRDH
Telephone Number : 937-212-9834
Provider Enumeration Date : 03/06/2024
Last Update Date : 06/30/2025

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Directions to “ESIESON HEALTH CARE GROUP LLC ” Practice Location

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