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General NPI Number Information
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NPI Number | 1225688617
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Entity Type | Organization
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Legal Business Name | THE ELI HOME, INC.
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 1175 N EAST ST
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City | ANAHEIM
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State | CA
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Zip | 92805-1429
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Country | US
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Telephone | 714-300-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 1175 N EAST ST
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City | ANAHEIM
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State | CA
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Zip | 92805-1429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LORRI GALLOWAY
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Credential |
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Telephone | 714-300-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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