Provider Demographics
NPI:1912750530
Name:ESSENTIAL HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:ESSENTIAL HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAKUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-319-7719
Mailing Address - Street 1:1909 104TH AVE E UNIT V306
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98372-1743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1909 104TH AVE E UNIT V306
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98372-1743
Practice Address - Country:US
Practice Address - Phone:978-319-7719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care