Provider Demographics
NPI: | 1871782847 |
---|---|
Name: | ELIADA HOMES, INC |
Entity type: | Organization |
Organization Name: | ELIADA HOMES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | REBECCA |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | WILLIAMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 828-254-5356 |
Mailing Address - Street 1: | 2 COMPTON DR |
Mailing Address - Street 2: | |
Mailing Address - City: | ASHEVILLE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28806-2054 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 828-254-5356 |
Mailing Address - Fax: | 828-210-0231 |
Practice Address - Street 1: | 2 COMPTON DR |
Practice Address - Street 2: | |
Practice Address - City: | ASHEVILLE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28806-2054 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-254-5356 |
Practice Address - Fax: | 828-210-0231 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-10-16 |
Last Update Date: | 2007-10-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | MHL- 11-262 | 323P00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |