Healthcare Provider Details

I. General information

NPI: 1194588996
Provider Name (Legal Business Name): ESMES PLACE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9309 CENTER ST STE 101
MANASSAS VA
20110-5599
US

IV. Provider business mailing address

9309 CENTER ST STE 101
MANASSAS VA
20110-5599
US

V. Phone/Fax

Practice location:
  • Phone: 703-546-1834
  • Fax:
Mailing address:
  • Phone: 703-546-1834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: JUDY JACOB
Title or Position: FOUNDER
Credential:
Phone: 703-546-1834