Healthcare Provider Details

I. General information

NPI: 1245098128
Provider Name (Legal Business Name): ESIESON HEALTH CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 POE AVE STE 170R4
DAYTON OH
45414-2792
US

IV. Provider business mailing address

6520 POE AVE STE 170R4
DAYTON OH
45414-2792
US

V. Phone/Fax

Practice location:
  • Phone: 937-212-9834
  • Fax:
Mailing address:
  • Phone: 937-387-9209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSIE E DIBO-NGALLE
Title or Position: CEO
Credential: BSRDH
Phone: 937-212-9834