Provider Demographics
NPI:1558914663
Name:ELIZABETH HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ELIZABETH HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS MBA
Authorized Official - Phone:214-584-7077
Mailing Address - Street 1:115 EXECUTIVE WAY STE 214
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2308
Mailing Address - Country:US
Mailing Address - Phone:972-224-1633
Mailing Address - Fax:
Practice Address - Street 1:115 EXECUTIVE WAY STE 214
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2308
Practice Address - Country:US
Practice Address - Phone:972-224-1633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care