Provider Demographics
NPI: | 1801362553 |
---|---|
Name: | ESSENTIAL SOLUTIONS INC. |
Entity Type: | Organization |
Organization Name: | ESSENTIAL SOLUTIONS INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SECRETARY/TREASURER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JEFF |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ANDERSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 606-454-1725 |
Mailing Address - Street 1: | 125 MULLINS ADDITION DR |
Mailing Address - Street 2: | |
Mailing Address - City: | PIKEVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 41501-2907 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 606-454-1725 |
Mailing Address - Fax: | 606-437-0713 |
Practice Address - Street 1: | 11105 US HIGHWAY 23 S |
Practice Address - Street 2: | |
Practice Address - City: | BETSY LAYNE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 41605-9998 |
Practice Address - Country: | US |
Practice Address - Phone: | 606-478-2433 |
Practice Address - Fax: | 606-478-2434 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-10-21 |
Last Update Date: | 2018-10-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Single Specialty |