Provider Demographics
NPI:1114082062
Name:ENES, INC
Entity Type:Organization
Organization Name:ENES, INC
Other - Org Name:LATE BLOOMERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTHANNA
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:GILLESPIE-LIEBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-343-7000
Mailing Address - Street 1:50 BEN FRANKLIN CT
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4041
Mailing Address - Country:US
Mailing Address - Phone:650-343-7000
Mailing Address - Fax:650-343-6203
Practice Address - Street 1:50 BEN FRANKLIN CT
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4041
Practice Address - Country:US
Practice Address - Phone:650-343-7000
Practice Address - Fax:650-343-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0265160001Medicare ID - Type Unspecified