MEDICARE: ELLIS BUSINESS GROUP LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		TX

General Provider Information

NPI Number	:	1790027761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLIS BUSINESS GROUP LLC.

Provider Business Mailing Address
First Line	:	4127 HARTSVILLE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-1218
Country	:	US
Telephone Number	:	281-819-7821
Fax Number	:	281-888-8964

Provider Business Practice Location Address
First Line	:	4127 HARTSVILLE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-1218
Country	:	US
Telephone Number	:	281-819-7821
Fax Number	:	281-888-8964

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NATARSHA NECOLE ELLIS
Credential	:
Telephone Number	:	281-819-7821

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	07/21/2022

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