Provider Demographics
NPI:1154074607
Name:ELISON HOME HEALTHCARE AGENCY, LLC
Entity Type:Organization
Organization Name:ELISON HOME HEALTHCARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PERKINS
Authorized Official - Middle Name:ELIJAH
Authorized Official - Last Name:OKECHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-674-9490
Mailing Address - Street 1:40 S JAMES RD STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1696
Mailing Address - Country:US
Mailing Address - Phone:614-674-9490
Mailing Address - Fax:
Practice Address - Street 1:40 S JAMES RD STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1696
Practice Address - Country:US
Practice Address - Phone:614-674-9490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health