Provider Demographics
NPI:1184212037
Name:ESTA IMMEDIATE HOMECARE
Entity type:Organization
Organization Name:ESTA IMMEDIATE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-712-9728
Mailing Address - Street 1:210 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3011
Mailing Address - Country:US
Mailing Address - Phone:207-712-9728
Mailing Address - Fax:
Practice Address - Street 1:210 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3011
Practice Address - Country:US
Practice Address - Phone:207-712-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health