Provider Demographics
NPI:1962465831
Name:ELS SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:ELS SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-727-0002
Mailing Address - Street 1:6501 ARLINGTON EXPY
Mailing Address - Street 2:SUITE #156-B
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5779
Mailing Address - Country:US
Mailing Address - Phone:904-727-0002
Mailing Address - Fax:904-727-5070
Practice Address - Street 1:6501 ARLINGTON EXPY
Practice Address - Street 2:SUITE #156-B
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5779
Practice Address - Country:US
Practice Address - Phone:904-727-0002
Practice Address - Fax:904-727-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services