=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457156929
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELARA CARING PCS IA 1, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2025
-----------------------------------------------------
Last Update Date | 02/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 N 7TH ST STE A
-----------------------------------------------------
City | CHARITON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50049-1206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 641-219-8311
-----------------------------------------------------
Fax | 641-903-2144
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3010 LYNDON B JOHNSON FWY STE 1100
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234-2712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-768-4373
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COMPLIANCE PRIVACY & SAFETY OFFICER
-----------------------------------------------------
Name | KATIE MONASTIERE
-----------------------------------------------------
Credential | CHC
-----------------------------------------------------
Telephone | 517-768-4373
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------