Provider Demographics
NPI:1528366754
Name:ELVIS HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ELVIS HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EBEN
Authorized Official - Last Name:EBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-924-7236
Mailing Address - Street 1:9535 FOREST LN STE 246
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5959
Mailing Address - Country:US
Mailing Address - Phone:469-372-0947
Mailing Address - Fax:469-420-5373
Practice Address - Street 1:9535 FOREST LN STE 246
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5959
Practice Address - Country:US
Practice Address - Phone:469-372-0947
Practice Address - Fax:469-420-5373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health