Provider Demographics
NPI:1467960443
Name:ELABORATE HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:ELABORATE HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:EYEGUE-SANDY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP, APRN
Authorized Official - Phone:202-294-8116
Mailing Address - Street 1:6480 NEW HAMPSHIRE AVE STE 301B
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4716
Mailing Address - Country:US
Mailing Address - Phone:202-294-8116
Mailing Address - Fax:
Practice Address - Street 1:6480 NEW HAMPSHIRE AVE STE 301B
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912
Practice Address - Country:US
Practice Address - Phone:202-294-8116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health