Provider Demographics
NPI:1134643406
Name:ESSENTIAL IN HOME HEALTH CARE
Entity Type:Organization
Organization Name:ESSENTIAL IN HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-701-1624
Mailing Address - Street 1:11290 WAMSUTTA TRL
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-7720
Mailing Address - Country:US
Mailing Address - Phone:314-688-2323
Mailing Address - Fax:
Practice Address - Street 1:11290 WAMSUTTA TRL
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-7720
Practice Address - Country:US
Practice Address - Phone:314-688-2323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health