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General NPI Number Information
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NPI Number | 1245098128
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Entity Type | Organization
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Legal Business Name | ESIESON HEALTH CARE GROUP LLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 6520 POE AVE STE 170R4
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City | DAYTON
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State | OH
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Zip | 45414-2792
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Country | US
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Telephone | 937-212-9834
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Fax |
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Provider Business Mailing Address
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Address Line | 6520 POE AVE STE 170R4
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City | DAYTON
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State | OH
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Zip | 45414-2792
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Country | US
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Telephone | 937-387-9209
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SUSIE E DIBO-NGALLE
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Credential | BSRDH
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Telephone | 937-212-9834
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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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