Provider Demographics
NPI:1780187757
Name:ESTHER'S HOME LLC
Entity Type:Organization
Organization Name:ESTHER'S HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:ABEL
Authorized Official - Last Name:BERNARDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-623-5275
Mailing Address - Street 1:3302 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1108
Mailing Address - Country:US
Mailing Address - Phone:703-623-5275
Mailing Address - Fax:
Practice Address - Street 1:3302 CAMPBELL DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1108
Practice Address - Country:US
Practice Address - Phone:703-623-5275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2442-01-001253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency