Provider Demographics
NPI:1578254801
Name:ESSENTIAL HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ESSENTIAL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELE
Authorized Official - Middle Name:LAWANNA
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:386-334-1476
Mailing Address - Street 1:16138 MONTEREY GREENS CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3788
Mailing Address - Country:US
Mailing Address - Phone:386-334-1476
Mailing Address - Fax:813-322-2034
Practice Address - Street 1:13506 N ROME AVE STE 107
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2027
Practice Address - Country:US
Practice Address - Phone:386-334-1476
Practice Address - Fax:813-322-2034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health