Provider Demographics
NPI:1699309112
Name:ESTERLINE ENTERPRISES
Entity type:Organization
Organization Name:ESTERLINE ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTERLINE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:517-266-7788
Mailing Address - Street 1:1801 W US HIGHWAY 223 STE 120
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-8479
Mailing Address - Country:US
Mailing Address - Phone:517-266-7788
Mailing Address - Fax:
Practice Address - Street 1:1801 W US HIGHWAY 223 STE 120
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-8479
Practice Address - Country:US
Practice Address - Phone:517-266-7788
Practice Address - Fax:517-266-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063750305OtherWE HAVE A PERSONAL NPI AS WELL