Provider Demographics
NPI:1871762872
Name:ELI HOME HEALTH SERVICES INC
Entity type:Organization
Organization Name:ELI HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ISIGUZO
Authorized Official - Last Name:OCHULOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-807-2727
Mailing Address - Street 1:9550 FOREST LANE, SUITE: 319
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5902
Mailing Address - Country:US
Mailing Address - Phone:469-867-2702
Mailing Address - Fax:972-807-2790
Practice Address - Street 1:9550 FOREST LANE, SUITE: 319
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5902
Practice Address - Country:US
Practice Address - Phone:469-867-2702
Practice Address - Fax:972-807-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
747088Medicare Oscar/Certification
TX747088Medicare Oscar/Certification