Provider Demographics
NPI:1952775660
Name:ESSENTIAL FAMILY SERVICES,LLC
Entity Type:Organization
Organization Name:ESSENTIAL FAMILY SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-207-2289
Mailing Address - Street 1:2219 MALLORY CIR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-2412
Mailing Address - Country:US
Mailing Address - Phone:863-207-2289
Mailing Address - Fax:
Practice Address - Street 1:705 INGRAHAM AVE
Practice Address - Street 2:SUITE #6
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4327
Practice Address - Country:US
Practice Address - Phone:863-207-2289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty