Provider Demographics
NPI:1902017775
Name:ELMWOOD KITCHEN, LLC
Entity Type:Organization
Organization Name:ELMWOOD KITCHEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-212-2310
Mailing Address - Street 1:1086 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-2429
Mailing Address - Country:US
Mailing Address - Phone:860-922-4466
Mailing Address - Fax:860-760-6305
Practice Address - Street 1:1086 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2429
Practice Address - Country:US
Practice Address - Phone:860-922-4466
Practice Address - Fax:860-760-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals