Provider Demographics
NPI:1790879542
Name:ESHNA, INC
Entity Type:Organization
Organization Name:ESHNA, INC
Other - Org Name:LAKE WHITNEY HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-697-6591
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-0458
Mailing Address - Country:US
Mailing Address - Phone:254-694-6626
Mailing Address - Fax:254-694-6391
Practice Address - Street 1:115 W. WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-2120
Practice Address - Country:US
Practice Address - Phone:254-694-6626
Practice Address - Fax:254-694-6391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009332251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
678387Medicare ID - Type Unspecified