Provider Demographics
NPI:1497817803
Name:ESSENCE OF LIFE LLC
Entity Type:Organization
Organization Name:ESSENCE OF LIFE LLC
Other - Org Name:ESSENCE OF LIFE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-626-4710
Mailing Address - Street 1:3207 220TH TRL
Mailing Address - Street 2:
Mailing Address - City:AMANA
Mailing Address - State:IA
Mailing Address - Zip Code:52203-8206
Mailing Address - Country:US
Mailing Address - Phone:319-622-3195
Mailing Address - Fax:319-622-3330
Practice Address - Street 1:3207 220TH TRL
Practice Address - Street 2:
Practice Address - City:AMANA
Practice Address - State:IA
Practice Address - Zip Code:52203-8206
Practice Address - Country:US
Practice Address - Phone:319-622-3195
Practice Address - Fax:319-622-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA161580Medicare Oscar/Certification