Healthcare Provider Details

I. General information

NPI: 1396549960
Provider Name (Legal Business Name): ESSOMID HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4507 WYNDTREE DR
WEST CHESTER OH
45069-8784
US

IV. Provider business mailing address

4507 WYNDTREE DR
WEST CHESTER OH
45069-8784
US

V. Phone/Fax

Practice location:
  • Phone: 513-300-5670
  • Fax: 513-300-5670
Mailing address:
  • Phone: 513-300-5670
  • Fax: 513-300-5670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDOU RAZACK KARAMA
Title or Position: DOO
Credential:
Phone: 513-300-5670