Provider Demographics
NPI:1538514963
Name:ELIANN PSYCH, LLC
Entity Type:Organization
Organization Name:ELIANN PSYCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUJIMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADEFISAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-205-3167
Mailing Address - Street 1:2150 PEACHFORD RD STE A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2150 PEACHFORD RD STE A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6521
Practice Address - Country:US
Practice Address - Phone:267-205-3167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty