MEDICARE: ELNAS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1114085560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELNAS, INC

Provider Business Mailing Address
First Line	:	3943 SOUTHERN BND
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6797
Country	:	US
Telephone Number	:	281-940-1839
Fax Number	:	281-394-3760

Provider Business Practice Location Address
First Line	:	3943 SOUTHERN BND
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6797
Country	:	US
Telephone Number	:	281-940-1839
Fax Number	:	281-394-3760

Authorized Official
Title or Position	:	CEO
Name	:	MRS. STELLA B.O OMOJOLA
Credential	:
Telephone Number	:	281-940-1839

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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