Provider Demographics
NPI:1922609734
Name:ENSOR HEALTH SERVICES
Entity Type:Organization
Organization Name:ENSOR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ENSOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-735-1317
Mailing Address - Street 1:13494 WALSINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3527
Mailing Address - Country:US
Mailing Address - Phone:727-735-1317
Mailing Address - Fax:
Practice Address - Street 1:12140 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-2421
Practice Address - Country:US
Practice Address - Phone:272-867-7716
Practice Address - Fax:727-286-8542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency