Provider Demographics
NPI:1225439052
Name:ELLM HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ELLM HEALTHCARE, LLC
Other - Org Name:HIGHLAND MEADOWS HEALTH & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-875-8185
Mailing Address - Street 1:1870 JOHN KING BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6216
Mailing Address - Country:US
Mailing Address - Phone:817-875-8185
Mailing Address - Fax:
Practice Address - Street 1:1870 JOHN KING BLVD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6216
Practice Address - Country:US
Practice Address - Phone:817-875-8185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000000Medicare Oscar/Certification