Healthcare Provider Details

I. General information

NPI: 1649983040
Provider Name (Legal Business Name): ECUMENICAL SUPPORT SERVICES FOR THE ELDERLY ESSE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 S EDGELAWN DR
AURORA IL
60506-4301
US

IV. Provider business mailing address

41 N PARK BLVD
GLEN ELLYN IL
60137-5713
US

V. Phone/Fax

Practice location:
  • Phone: 630-791-9319
  • Fax: 630-260-8046
Mailing address:
  • Phone: 630-260-3773
  • Fax: 630-260-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHY C DAVIT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 630-260-3773