Provider Demographics
NPI:1790378826
Name:ENE SELFCARE ESSENTIALS LLC
Entity Type:Organization
Organization Name:ENE SELFCARE ESSENTIALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANTIZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-580-6146
Mailing Address - Street 1:1843 MORGANA RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-4110
Mailing Address - Country:US
Mailing Address - Phone:904-580-6146
Mailing Address - Fax:904-782-6860
Practice Address - Street 1:50 N LAURA ST STE 2500
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-3646
Practice Address - Country:US
Practice Address - Phone:904-580-6146
Practice Address - Fax:904-782-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty