Provider Demographics
NPI:1245098128
Name:ESIESON HEALTH CARE GROUP LLC
Entity type:Organization
Organization Name:ESIESON HEALTH CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:DIBO-NGALLE
Authorized Official - Suffix:
Authorized Official - Credentials:BSRDH
Authorized Official - Phone:937-212-9834
Mailing Address - Street 1:6520 POE AVE STE 170R4
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2792
Mailing Address - Country:US
Mailing Address - Phone:937-387-9209
Mailing Address - Fax:
Practice Address - Street 1:6520 POE AVE STE 170
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2858
Practice Address - Country:US
Practice Address - Phone:937-387-9209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health