Provider Demographics
NPI:1285312710
Name:THE ESSENCE OF TRUE LIVING INC
Entity type:Organization
Organization Name:THE ESSENCE OF TRUE LIVING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:803-540-5769
Mailing Address - Street 1:11121 NOLET CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-7393
Mailing Address - Country:US
Mailing Address - Phone:803-540-5769
Mailing Address - Fax:
Practice Address - Street 1:7725 LINDA LAKE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-2846
Practice Address - Country:US
Practice Address - Phone:704-560-6131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home