Provider Demographics
NPI:1417255795
Name:ELIJAH HEALTH CARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:ELIJAH HEALTH CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ANNETT
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-210-4474
Mailing Address - Street 1:272 KYLE SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-4890
Mailing Address - Country:US
Mailing Address - Phone:770-210-4474
Mailing Address - Fax:770-210-4475
Practice Address - Street 1:1547 STOCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3742
Practice Address - Country:US
Practice Address - Phone:770-210-4474
Practice Address - Fax:770-210-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031-R-0581251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care