Provider Demographics
NPI:1184843351
Name:ELKHART COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ELKHART COUNTY HEALTH DEPARTMENT
Other - Org Name:HEALTHY BEGINNINGS
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AIXSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-523-2105
Mailing Address - Street 1:608 OAKLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516
Mailing Address - Country:US
Mailing Address - Phone:574-523-2105
Mailing Address - Fax:574-295-6186
Practice Address - Street 1:1400 HUDSON STREET
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516
Practice Address - Country:US
Practice Address - Phone:574-522-0104
Practice Address - Fax:574-522-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty