Provider Demographics
NPI:1952644262
Name:ESSENCE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ESSENCE HEALTHCARE LLC
Other - Org Name:ESSENCE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:949-723-0585
Mailing Address - Street 1:711 W 17TH ST
Mailing Address - Street 2:C2
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-4350
Mailing Address - Country:US
Mailing Address - Phone:949-723-0585
Mailing Address - Fax:888-909-0694
Practice Address - Street 1:711 W 17TH ST
Practice Address - Street 2:C2
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4350
Practice Address - Country:US
Practice Address - Phone:949-723-0585
Practice Address - Fax:888-909-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based