Healthcare Provider Details

I. General information

NPI: 1366372260
Provider Name (Legal Business Name): ESSENTIAL HOMECARE PROVIDER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 MCWILLIAMS RD SE
ATLANTA GA
30315-8607
US

IV. Provider business mailing address

725 MCWILLIAMS RD SE
ATLANTA GA
30315-8607
US

V. Phone/Fax

Practice location:
  • Phone: 470-202-2772
  • Fax: 470-625-3366
Mailing address:
  • Phone: 470-202-2772
  • Fax: 470-625-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SHEVAN OBRIAN HOWARD
Title or Position: OWNER
Credential: PHD
Phone: 470-202-2772