Provider Demographics
NPI:1639769193
Name:ELIM TOTAL HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ELIM TOTAL HEALTHCARE SERVICES
Other - Org Name:ELIM HOME HEALTH CARE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKERULU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-294-9875
Mailing Address - Street 1:3202 DOGWOOD KNOLL TRL
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6702
Mailing Address - Country:US
Mailing Address - Phone:347-294-9875
Mailing Address - Fax:183-202-0808
Practice Address - Street 1:3202 DOGWOOD KNOLL TRL
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6702
Practice Address - Country:US
Practice Address - Phone:347-294-9875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:021201
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-19
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty