Provider Demographics
NPI:1417162520
Name:ESTHERS PLACE
Entity Type:Organization
Organization Name:ESTHERS PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ERDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:410-371-9806
Mailing Address - Street 1:11056 CHAMBERS CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163
Mailing Address - Country:US
Mailing Address - Phone:410-371-9806
Mailing Address - Fax:
Practice Address - Street 1:2901 E STRATHMORE AVE
Practice Address - Street 2:2802 PINEWOOD AVE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2514
Practice Address - Country:US
Practice Address - Phone:410-371-9806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30AL845310400000X
MD30AL420310400000X
MD30AL2271311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility