MEDICARE: ELSHADAI GROUP, INC.

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

General Provider Information

NPI Number	:	1912168626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELSHADAI GROUP, INC.

Provider Business Mailing Address
First Line	:	1421 ATKINS ST
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-8121
Country	:	US
Telephone Number	:	214-715-5725
Fax Number	:	972-291-3176

Provider Business Practice Location Address
First Line	:	1421 ATKINS ST
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-8121
Country	:	US
Telephone Number	:	214-715-5725
Fax Number	:	972-291-3176

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ELIZABETH O AYORINDE
Credential	:
Telephone Number	:	214-715-5725

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	06/24/2008

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