Provider Demographics
NPI:1386496594
Name:ESSENCE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:ESSENCE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHUN
Authorized Official - Middle Name:RL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:314-773-9343
Mailing Address - Street 1:247 BROOKMONT DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-7121
Mailing Address - Country:US
Mailing Address - Phone:314-773-9343
Mailing Address - Fax:
Practice Address - Street 1:2127 VICTOR ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-2841
Practice Address - Country:US
Practice Address - Phone:314-773-9343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health