Provider Demographics
NPI:1689303638
Name:ELI HEALTHCARE LLC
Entity Type:Organization
Organization Name:ELI HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-845-3213
Mailing Address - Street 1:1881 TRAVERSE PARKWAY
Mailing Address - Street 2:SUITE E #112
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043
Mailing Address - Country:US
Mailing Address - Phone:801-455-8571
Mailing Address - Fax:801-335-6402
Practice Address - Street 1:5882 S 900 E STE 101
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-1688
Practice Address - Country:US
Practice Address - Phone:801-542-7150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health