Provider Demographics
NPI:1326789835
Name:ESSENTIAL IN-HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:ESSENTIAL IN-HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOURDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-228-2162
Mailing Address - Street 1:425 SUMMIT TERRACE CT BLDG 4
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7056
Mailing Address - Country:US
Mailing Address - Phone:803-228-2162
Mailing Address - Fax:
Practice Address - Street 1:425 SUMMIT TERRACE CT BLDG 4
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7056
Practice Address - Country:US
Practice Address - Phone:803-228-2162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care