Provider Demographics
NPI:1811900376
Name:ESTHER'S PLACE, INC.
Entity type:Organization
Organization Name:ESTHER'S PLACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARI
Authorized Official - Middle Name:
Authorized Official - Last Name:TIGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:BA, QP
Authorized Official - Phone:828-217-1691
Mailing Address - Street 1:PO BOX 9593
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-9593
Mailing Address - Country:US
Mailing Address - Phone:828-217-1691
Mailing Address - Fax:828-449-5892
Practice Address - Street 1:765 8TH AVENUE DR SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-3933
Practice Address - Country:US
Practice Address - Phone:828-217-1691
Practice Address - Fax:828-449-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
NCMHL-018-070322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health