Healthcare Provider Details

I. General information

NPI: 1174387252
Provider Name (Legal Business Name): ELOCIN ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 WEBSTER LN
PALM COAST FL
32164-7783
US

IV. Provider business mailing address

104 WEBSTER LN
PALM COAST FL
32164-7783
US

V. Phone/Fax

Practice location:
  • Phone: 726-230-8197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. ALEXIS HARBELIS
Title or Position: CEO/EXECUTIVE DIRECTOR
Credential: RN
Phone: 726-230-8197