Provider Demographics
NPI:1104632892
Name:ELEGANT HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:ELEGANT HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDILLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-901-1512
Mailing Address - Street 1:2626 HILLIARD PLACE DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8458
Mailing Address - Country:US
Mailing Address - Phone:740-901-1512
Mailing Address - Fax:
Practice Address - Street 1:2626 HILLIARD PLACE DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8458
Practice Address - Country:US
Practice Address - Phone:740-901-1512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health