Provider Demographics
NPI:1629576947
Name:ELABORATE HOME HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:ELABORATE HOME HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EYEGUE-SANDY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, CRNP
Authorized Official - Phone:215-594-9392
Mailing Address - Street 1:6413 RIVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-2914
Mailing Address - Country:US
Mailing Address - Phone:202-294-8116
Mailing Address - Fax:
Practice Address - Street 1:6413 RIVINGTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2914
Practice Address - Country:US
Practice Address - Phone:703-935-9442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care