Provider Demographics
NPI:1972065142
Name:ELEOS FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:ELEOS FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MARTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-842-1056
Mailing Address - Street 1:3854 CARRICK BEND DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-2974
Mailing Address - Country:US
Mailing Address - Phone:973-842-1056
Mailing Address - Fax:
Practice Address - Street 1:3854 CARRICK BEND DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-2974
Practice Address - Country:US
Practice Address - Phone:973-842-1056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health