Healthcare Provider Details

I. General information

NPI: 1477786986
Provider Name (Legal Business Name): ESSENTIALLY COPING & CARING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 10/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4924A WINDY HILL DR
RALEIGH NC
27609-4930
US

IV. Provider business mailing address

7105 BEAVERWOOD DR
RALEIGH NC
27616-6404
US

V. Phone/Fax

Practice location:
  • Phone: 919-790-6662
  • Fax: 919-872-0403
Mailing address:
  • Phone: 919-452-5245
  • Fax: 919-872-0403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral 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: MRS. GWENDOLYN M WEBB
Title or Position: CFO
Credential:
Phone: 919-452-5245