Healthcare Provider Details

I. General information

NPI: 1659737187
Provider Name (Legal Business Name): ESSENTIAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 E 12TH ST
KANSAS CITY MO
64106-3233
US

IV. Provider business mailing address

1314 NW 47TH ST
KANSAS CITY MO
64116-4632
US

V. Phone/Fax

Practice location:
  • Phone: 913-915-0001
  • Fax:
Mailing address:
  • Phone: 913-915-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberL1467573760
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberL1467573760
License Number StateMO

VIII. Authorized Official

Name: MARIAN R THUSTON
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 913-915-0001