Provider Demographics
NPI:1447559745
Name:ESSENTIAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ESSENTIAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VALENCIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, BSN, MS, RN
Authorized Official - Phone:404-583-7555
Mailing Address - Street 1:397 SUNDERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7957
Mailing Address - Country:US
Mailing Address - Phone:404-583-7555
Mailing Address - Fax:
Practice Address - Street 1:397 SUNDERLAND WAY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7957
Practice Address - Country:US
Practice Address - Phone:404-583-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN159847251B00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care