Provider Demographics
NPI:1861836199
Name:ESSENTIAL COMPANION CARE SERVICES
Entity Type:Organization
Organization Name:ESSENTIAL COMPANION CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIELISIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-301-0209
Mailing Address - Street 1:8906 E SKELLY DR
Mailing Address - Street 2:SUITE T
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74129-3400
Mailing Address - Country:US
Mailing Address - Phone:918-301-0209
Mailing Address - Fax:
Practice Address - Street 1:8906 E SKELLY DR
Practice Address - Street 2:SUITE T
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-3400
Practice Address - Country:US
Practice Address - Phone:918-301-0209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care