Provider Demographics
NPI:1144973645
Name:ESSENCE FAMILY CARE SERVICE
Entity type:Organization
Organization Name:ESSENCE FAMILY CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-546-1834
Mailing Address - Street 1:223 GREEN DR
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-2603
Mailing Address - Country:US
Mailing Address - Phone:800-820-0706
Mailing Address - Fax:
Practice Address - Street 1:223 GREEN DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-2603
Practice Address - Country:US
Practice Address - Phone:800-820-0706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003282000Medicaid