Healthcare Provider Details

I. General information

NPI: 1376543512
Provider Name (Legal Business Name): ESPRIT HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 EVERGREEN LN # 101
ANNANDALE VA
22003-3210
US

IV. Provider business mailing address

4209 EVERGREEN LN 101
ANNANDALE VA
22003-3210
US

V. Phone/Fax

Practice location:
  • Phone: 703-998-7400
  • Fax: 703-998-6700
Mailing address:
  • Phone: 703-998-7400
  • Fax: 703-998-6700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. FEKERTE T ABRAHAM
Title or Position: ADMIN
Credential: ADMIN
Phone: 703-389-0320