Provider Demographics
NPI:1396433587
Name:ENSIGHT HOME CARE LLC
Entity type:Organization
Organization Name:ENSIGHT HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-456-7456
Mailing Address - Street 1:3197 W 650 N
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-6809
Mailing Address - Country:US
Mailing Address - Phone:801-759-8975
Mailing Address - Fax:
Practice Address - Street 1:3197 W 650 N
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-6809
Practice Address - Country:US
Practice Address - Phone:801-759-8975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care