Healthcare Provider Details

I. General information

NPI: 1972449858
Provider Name (Legal Business Name): ENESCENCE COMMUNITY SERVICES AND SUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 BRIARWOOD ST
SAPULPA OK
74066
US

IV. Provider business mailing address

7521 S OLYMPIA AVE # 1042
TULSA OK
74132-1855
US

V. Phone/Fax

Practice location:
  • Phone: 972-330-7697
  • Fax:
Mailing address:
  • Phone: 972-330-7697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH HOLMES
Title or Position: CEO
Credential:
Phone: 972-330-7697