Healthcare Provider Details

I. General information

NPI: 1376398255
Provider Name (Legal Business Name): ESSENTIAL SERVICES FOR YOU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11157 W COLONIAL DR
OCOEE FL
34761-2935
US

IV. Provider business mailing address

11157 W COLONIAL DR
OCOEE FL
34761-2935
US

V. Phone/Fax

Practice location:
  • Phone: 404-277-4470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN WALLACE
Title or Position: CEO
Credential:
Phone: 607-592-4205