Provider Demographics
NPI:1588147045
Name:ESIT, LLC
Entity type:Organization
Organization Name:ESIT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:318-820-6857
Mailing Address - Street 1:3413 NATHAN CIR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71108-5343
Mailing Address - Country:US
Mailing Address - Phone:318-820-6857
Mailing Address - Fax:
Practice Address - Street 1:7505 PINES RD STE 1200E
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3935
Practice Address - Country:US
Practice Address - Phone:318-820-6857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities