Provider Demographics
NPI:1639631021
Name:ELIJAH FAMILY HOMES
Entity Type:Organization
Organization Name:ELIJAH FAMILY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-943-6610
Mailing Address - Street 1:660 GEORGE WASHINGTON WAY STE G
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4246
Mailing Address - Country:US
Mailing Address - Phone:509-943-6610
Mailing Address - Fax:509-943-6645
Practice Address - Street 1:660 GEORGE WASHINGTON WAY STE G
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4246
Practice Address - Country:US
Practice Address - Phone:509-943-6610
Practice Address - Fax:509-943-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management