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General NPI Number Information
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NPI Number | 1215500186
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Entity Type | Organization
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Legal Business Name | ESSENTIAL CONNECTIONS LLC
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 859 GAIRLOCH LN
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City | FORT PIERCE
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State | FL
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Zip | 34947-1341
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Country | US
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Telephone | 772-828-6911
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Fax |
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Provider Business Mailing Address
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Address Line | 859 GAIRLOCH LN
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City | FORT PIERCE
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State | FL
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Zip | 34947-1341
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Country | US
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Telephone | 772-828-6911
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SABRINA TROUTMAN
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Credential |
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Telephone | 772-828-6911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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