Healthcare Provider Details
I. General information
NPI: 1114376118
Provider Name (Legal Business Name): ELEON HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2016
Last Update Date: 06/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 PASSAIC ST SUITE 5
HACKENSACK NJ
07601-3525
US
IV. Provider business mailing address
2145 OCEAN AVE APT D10
BROOKLYN NY
11229-1446
US
V. Phone/Fax
- Phone: 347-424-5309
- Fax:
- Phone: 347-424-5309
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
EKATERINA
BARNARD
Title or Position: OWNER
Credential:
Phone: 347-424-5309