Provider Demographics
NPI:1205226891
Name:ELAN ACADEMIES
Entity Type:Organization
Organization Name:ELAN ACADEMIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-966-2312
Mailing Address - Street 1:3158 RED HILL AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3428
Mailing Address - Country:US
Mailing Address - Phone:714-966-2312
Mailing Address - Fax:714-966-2317
Practice Address - Street 1:3158 RED HILL AVE STE 150
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3428
Practice Address - Country:US
Practice Address - Phone:714-966-2312
Practice Address - Fax:714-966-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22346103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty