Healthcare Provider Details

I. General information

NPI: 1154986479
Provider Name (Legal Business Name): ELP RIGHT LIVING HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 EAGANDALE PL #101
EAGAN MN
55121
US

IV. Provider business mailing address

3035 EAGANDALE PL #101
EAGAN MN
55121
US

V. Phone/Fax

Practice location:
  • Phone: 818-401-5101
  • Fax: 651-454-5383
Mailing address:
  • Phone: 818-401-5101
  • Fax: 651-454-5383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: PHOEBE NANCY NAMULUTA
Title or Position: OWNER/CHIEF OPERATIONS OFFICER
Credential:
Phone: 818-401-5101