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General NPI Number Information
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NPI Number | 1952775660
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Entity Type | Organization
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Legal Business Name | ESSENTIAL FAMILY SERVICES,LLC
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 705 INGRAHAM AVE SUITE #6
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City | HAINES CITY
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State | FL
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Zip | 33844-4327
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Country | US
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Telephone | 863-207-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 2219 MALLORY CIR
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City | HAINES CITY
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State | FL
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Zip | 33844-2412
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Country | US
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Telephone | 863-207-2289
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MICHELLE RODRIGUEZ
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Credential |
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Telephone | 863-207-2289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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