Provider Demographics
NPI:1881682680
Name:ELIM HOMES, INC.
Entity Type:Organization
Organization Name:ELIM HOMES, INC.
Other - Org Name:ELIM OASIS ADULT DAY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SEELOCHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:STADTHERR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-855-5041
Mailing Address - Street 1:701 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371-1713
Mailing Address - Country:US
Mailing Address - Phone:763-389-1171
Mailing Address - Fax:763-389-0432
Practice Address - Street 1:701 1ST ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-1713
Practice Address - Country:US
Practice Address - Phone:763-389-1171
Practice Address - Fax:763-389-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
MN328424314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN328424OtherSTATE LICENSE NUMBER
MN615342900Medicaid