Healthcare Provider Details

I. General information

NPI: 1932011608
Provider Name (Legal Business Name): ESSENTIALS OF LIFE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 WATERS EDGE DR STE 206
RALEIGH NC
27606-2462
US

IV. Provider business mailing address

6847 MIDDLEBORO DR
RALEIGH NC
27612-2670
US

V. Phone/Fax

Practice location:
  • Phone: 919-389-2170
  • Fax:
Mailing address:
  • Phone: 919-389-2170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DOMINIQUE FLEMMING
Title or Position: DIRECTOR
Credential: HOME CARE PROVIDER
Phone: 919-389-2170