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General NPI Number Information
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NPI Number | 1972449858
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Entity Type | Organization
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Legal Business Name | ENESCENCE COMMUNITY SERVICES AND SUPPORT
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 4 BRIARWOOD ST
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City | SAPULPA
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State | OK
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Zip | 74066
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Country | US
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Telephone | 972-330-7697
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Fax |
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Provider Business Mailing Address
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Address Line | 7521 S OLYMPIA AVE # 1042
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City | TULSA
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State | OK
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Zip | 74132-1855
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Country | US
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Telephone | 972-330-7697
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEBORAH HOLMES
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Credential |
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Telephone | 972-330-7697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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