Provider Demographics
NPI:1952343725
Name:ESSENTIAL HOME HEALTH, LLC
Entity Type:Organization
Organization Name:ESSENTIAL HOME HEALTH, LLC
Other - Org Name:PHOENIX HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-688-5511
Mailing Address - Street 1:6803 W 64TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4128
Mailing Address - Country:US
Mailing Address - Phone:913-384-2273
Mailing Address - Fax:913-384-0688
Practice Address - Street 1:6803 W 64TH ST STE 101
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4128
Practice Address - Country:US
Practice Address - Phone:913-384-2273
Practice Address - Fax:913-384-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200425960BMedicaid
178077OtherMEDICARE NUMBER