Provider Demographics
NPI:1225807050
Name:ELROI IDD, LLC
Entity Type:Organization
Organization Name:ELROI IDD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CENATUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-225-5922
Mailing Address - Street 1:885 BRANDYWINE ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-5425
Mailing Address - Country:US
Mailing Address - Phone:409-225-5922
Mailing Address - Fax:409-225-5922
Practice Address - Street 1:885 BRANDYWINE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-5425
Practice Address - Country:US
Practice Address - Phone:409-225-5922
Practice Address - Fax:409-225-5922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
Yes282E00000XHospitalsLong Term Care Hospital
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No385H00000XRespite Care FacilityRespite Care