Provider Demographics
NPI:1023627452
Name:ELYON HOME HEALTHCARE, LLC.
Entity type:Organization
Organization Name:ELYON HOME HEALTHCARE, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:KWEKU
Authorized Official - Last Name:BANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-484-6464
Mailing Address - Street 1:15337 BARNABAS TRL
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5566
Mailing Address - Country:US
Mailing Address - Phone:571-484-6464
Mailing Address - Fax:703-986-0717
Practice Address - Street 1:18139 TRIANGLE SHOPPING PLZ STE 213
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2582
Practice Address - Country:US
Practice Address - Phone:703-986-0161
Practice Address - Fax:703-986-0717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health