Healthcare Provider Details

I. General information

NPI: 1396433587
Provider Name (Legal Business Name): ENSIGHT HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3197 W 650 N
CLEARFIELD UT
84015-6809
US

IV. Provider business mailing address

3197 W 650 N
CLEARFIELD UT
84015-6809
US

V. Phone/Fax

Practice location:
  • Phone: 801-759-8975
  • Fax:
Mailing address:
  • Phone: 801-759-8975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER J LUI
Title or Position: CEO
Credential:
Phone: 385-456-7456