Healthcare Provider Details

I. General information

NPI: 1447402144
Provider Name (Legal Business Name): ESSENTIAL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4051 ULLOA STREET
NEW ORLEANS LA
70119-5254
US

IV. Provider business mailing address

4051 ULLOA STREET
NEW ORLEANS LA
70119-5254
US

V. Phone/Fax

Practice location:
  • Phone: 504-267-5712
  • Fax: 504-267-5714
Mailing address:
  • Phone: 504-267-5712
  • Fax: 504-267-5714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. TYRA RICKS GONZALEZ
Title or Position: C.E.O.
Credential:
Phone: 504-231-7066