Provider Demographics
NPI:1861814006
Name:E.S.S.I.E., LLC
Entity type:Organization
Organization Name:E.S.S.I.E., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDER
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:248-423-9245
Mailing Address - Street 1:6689 ORCHARD LAKE RD
Mailing Address - Street 2:# 216
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3404
Mailing Address - Country:US
Mailing Address - Phone:248-423-9245
Mailing Address - Fax:248-423-3716
Practice Address - Street 1:6689 ORCHARD LAKE RD
Practice Address - Street 2:# 216
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3404
Practice Address - Country:US
Practice Address - Phone:248-423-9245
Practice Address - Fax:248-423-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAEN019258261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care