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General NPI Number Information
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NPI Number | 1093320202
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HOME CARE LLC
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 758 2ND STREET PIKE
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-3972
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Country | US
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Telephone | 999-999-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 20 W 47TH ST STE 801
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City | NEW YORK
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State | NY
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Zip | 10036-3303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ISKIJA ABRAMOV
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Credential |
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Telephone | 999-999-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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