Provider Demographics
NPI:1821439282
Name:ESSENTIAL HEALTH LLC
Entity Type:Organization
Organization Name:ESSENTIAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:MATTISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:908-454-8808
Mailing Address - Street 1:480 MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1575
Mailing Address - Country:US
Mailing Address - Phone:908-454-8808
Mailing Address - Fax:908-998-4762
Practice Address - Street 1:480 MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1575
Practice Address - Country:US
Practice Address - Phone:908-454-8808
Practice Address - Fax:908-998-4762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00514100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ319724OtherMEDICARE