Healthcare Provider Details

I. General information

NPI: 1053277152
Provider Name (Legal Business Name): ESSENTIAL HEALTH AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 ROCHDALE LN
SUFFOLK VA
23434-2189
US

IV. Provider business mailing address

168 ROCHDALE LN
SUFFOLK VA
23434-2189
US

V. Phone/Fax

Practice location:
  • Phone: 757-739-3107
  • Fax: 757-739-3107
Mailing address:
  • Phone: 757-739-3107
  • Fax: 757-739-3107

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: BUKKY IYABO YUSUF-OGUNJIMI
Title or Position: OWNER
Credential:
Phone: 757-739-3107