Provider Demographics
NPI:1649488974
Name:ELPA HOME CARE
Entity type:Organization
Organization Name:ELPA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ARELYS
Authorized Official - Middle Name:F
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-412-7710
Mailing Address - Street 1:9950 SW 83RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4012
Mailing Address - Country:US
Mailing Address - Phone:305-228-1444
Mailing Address - Fax:302-225-1289
Practice Address - Street 1:9950 SW, 83 ST.
Practice Address - Street 2:9950 SW, 83 ST
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-412-7710
Practice Address - Fax:305-412-7710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 5260310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141596400Medicaid