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General NPI Number Information
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NPI Number | 1114302742
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Entity Type | Organization
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Legal Business Name | ELIXIR HOME HEALTH CARE & HOSPICE,INC.
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 1420 W KETTLEMAN LN SUITE S2
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City | LODI
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State | CA
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Zip | 95242-4557
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Country | US
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Telephone | 209-369-5110
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Fax | 209-396-5130
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Provider Business Mailing Address
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Address Line | 1420 W KETTLEMAN LN SUITE S2
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City | LODI
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State | CA
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Zip | 95242-4557
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Country | US
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Telephone | 209-369-5110
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Fax | 209-396-5130
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAVED WAHAB
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Credential |
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Telephone | 209-369-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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