Healthcare Provider Details

I. General information

NPI: 1578555017
Provider Name (Legal Business Name): ESSENTIAL HEALTH SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E. MARSHALL
VAN ALSTYNE TX
75495-9998
US

IV. Provider business mailing address

PO BOX 864
VAN ALSTYNE TX
75495-9998
US

V. Phone/Fax

Practice location:
  • Phone: 903-482-6400
  • Fax: 903-482-6403
Mailing address:
  • Phone: 903-482-6400
  • Fax: 903-482-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number008292
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JACKIE C BROWNE
Title or Position: MANAGER, ADMINISTRATOR
Credential:
Phone: 918-465-2626