Provider Demographics
NPI:1376543512
Name:ESPRIT HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:ESPRIT HOME HEALTHCARE LLC
Other - Org Name:ESPRIT HOME HEALTHCARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:FEKERTE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIN
Authorized Official - Phone:703-389-0320
Mailing Address - Street 1:4209 EVERGREEN LN
Mailing Address - Street 2:101
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3210
Mailing Address - Country:US
Mailing Address - Phone:703-998-7400
Mailing Address - Fax:703-998-6700
Practice Address - Street 1:4209 EVERGREEN LN # 101
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3210
Practice Address - Country:US
Practice Address - Phone:703-998-7400
Practice Address - Fax:703-998-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1376543512Medicaid
VA004970098Medicaid