Provider Demographics
NPI:1326827601
Name:ELPIS EMPOWERMENT CENTER LLC
Entity Type:Organization
Organization Name:ELPIS EMPOWERMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUZUNGU
Authorized Official - Middle Name:MAXIME
Authorized Official - Last Name:SHENDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-361-6910
Mailing Address - Street 1:7372 CAMBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-5518
Mailing Address - Country:US
Mailing Address - Phone:859-361-6910
Mailing Address - Fax:
Practice Address - Street 1:7372 CAMBRIDGE PL
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-5518
Practice Address - Country:US
Practice Address - Phone:859-361-6910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities