Provider Demographics
NPI:1437549474
Name:ESTHON HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:ESTHON HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ONIFADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-476-1990
Mailing Address - Street 1:47 PEABODY ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1546
Mailing Address - Country:US
Mailing Address - Phone:240-476-1990
Mailing Address - Fax:
Practice Address - Street 1:47 PEABODY ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1546
Practice Address - Country:US
Practice Address - Phone:240-476-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services