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General NPI Number Information
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NPI Number | 1841720570
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Entity Type | Organization
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Legal Business Name | ELDORADO HEALTHCARE MANAGEMENT, LLC
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 325 ALPHA PARK
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City | HIGHLAND HTS
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State | OH
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Zip | 44143-2237
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Country | US
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Telephone | 217-704-7337
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Fax |
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Provider Business Mailing Address
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Address Line | 4991 CORLISS RD
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City | LYNDHURST
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State | OH
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Zip | 44124-1130
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Country | US
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Telephone | 216-704-7337
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Fax |
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Authorized Official
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Title or Position | OWNER/DON
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Name | MRS. ZHANNA ISKHAKOVA
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Credential |
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Telephone | 216-704-7337
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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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