Provider Demographics
NPI:1477285096
Name:ESSENTIAL NEEDS SERVICES LLC
Entity Type:Organization
Organization Name:ESSENTIAL NEEDS SERVICES LLC
Other - Org Name:ESSENTIAL NEEDS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CO-OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELVIN-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-250-6060
Mailing Address - Street 1:5575 SIMMONS ST UNIT 1-136
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-9009
Mailing Address - Country:US
Mailing Address - Phone:725-250-6060
Mailing Address - Fax:
Practice Address - Street 1:5575 SIMMONS ST UNIT 1-136
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-9009
Practice Address - Country:US
Practice Address - Phone:725-250-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)