Healthcare Provider Details

I. General information

NPI: 1811175748
Provider Name (Legal Business Name): ESSENCE IN-HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4358 PAPAL DR
FLORISSANT MO
63033-7012
US

IV. Provider business mailing address

4358 PAPAL DR
FLORISSANT MO
63033-7012
US

V. Phone/Fax

Practice location:
  • Phone: 314-369-6211
  • Fax: 314-839-5914
Mailing address:
  • Phone: 314-839-5914
  • Fax: 314-839-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number19977697
License Number StateMO

VIII. Authorized Official

Name: MRS. LINDA SLATER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 314-369-6211