Provider Demographics
NPI: | 1376963538 |
---|---|
Name: | ES HEALTH SERVICES, LLC |
Entity Type: | Organization |
Organization Name: | ES HEALTH SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | FAMILY SPECIALIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KIM |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | NWAGWU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 248-212-7216 |
Mailing Address - Street 1: | 46931 ELMSMERE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTHVILLE |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48167-3302 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 50844 BRIAR RIDGE LN |
Practice Address - Street 2: | |
Practice Address - City: | NORTHVILLE |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48168-6878 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-212-7216 |
Practice Address - Fax: | 248-233-6373 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-04-25 |
Last Update Date: | 2022-08-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101Y00000X, 103TB0200X, 103TF0000X, 103TP2701X, 104100000X, 1041C0700X, 171M00000X, 2084P0800X, 225X00000X, 261QM0801X, 261QM0850X, 261QP2000X, 372500000X, 374U00000X | ||
MI | 253Z00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | Group - Multi-Specialty |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 253Z00000X | Agencies | In Home Supportive Care | Group - Multi-Specialty | |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Multi-Specialty |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Multi-Specialty |
No | 372500000X | Nursing Service Related Providers | Chore Provider | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty |