Healthcare Provider Details

I. General information

NPI: 1609528082
Provider Name (Legal Business Name): ESSIE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 W NORTH BEND RD
CINCINNATI OH
45224-2210
US

IV. Provider business mailing address

8721 COLERAIN AVE # 531621
CINCINNATI OH
45251-2917
US

V. Phone/Fax

Practice location:
  • Phone: 513-512-0573
  • Fax:
Mailing address:
  • Phone: 833-377-4312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome 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: MISS VESCHELLEY DENISE PHELPS
Title or Position: OWNER
Credential:
Phone: 833-377-4312