Healthcare Provider Details

I. General information

NPI: 1003958935
Provider Name (Legal Business Name): ELP COMMUNITY HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PHIL HANSEN DR
CANUTILLO TX
79835-8311
US

IV. Provider business mailing address

513 PHIL HANSEN DR
CANUTILLO TX
79835-8311
US

V. Phone/Fax

Practice location:
  • Phone: 915-587-9994
  • Fax: 915-833-0922
Mailing address:
  • Phone: 915-587-9994
  • Fax: 915-833-0922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009014
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA MAZIE KALU
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 915-587-9994