Provider Demographics
NPI:1003605239
Name:WILLING GIFT RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:WILLING GIFT RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BERTRAND
Authorized Official - Middle Name:
Authorized Official - Last Name:ESIENGWO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:216-780-1461
Mailing Address - Street 1:2507 GOLDENGATE SQ N APT M
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-1639
Mailing Address - Country:US
Mailing Address - Phone:216-780-1461
Mailing Address - Fax:
Practice Address - Street 1:2507 GOLDENGATE SQ N APT M
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-1639
Practice Address - Country:US
Practice Address - Phone:216-780-1461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty