Provider Demographics
NPI:1568799823
Name:ESSENCE OF CARE2
Entity Type:Organization
Organization Name:ESSENCE OF CARE2
Other - Org Name:ESSENCE OF CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-772-6946
Mailing Address - Street 1:1400 BATTLEGROUND AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8042
Mailing Address - Country:US
Mailing Address - Phone:336-272-3095
Mailing Address - Fax:336-272-3088
Practice Address - Street 1:1400 BATTLEGROUND AVE STE 150
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8042
Practice Address - Country:US
Practice Address - Phone:336-272-3095
Practice Address - Fax:336-272-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health