Provider Demographics
NPI:1700331022
Name:ELEEO HOME HEALTH CARE
Entity Type:Organization
Organization Name:ELEEO HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ZENISEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-355-9055
Mailing Address - Street 1:482 POINT DOUGLAS RD S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5368
Mailing Address - Country:US
Mailing Address - Phone:651-355-9055
Mailing Address - Fax:651-355-9055
Practice Address - Street 1:482 POINT DOUGLAS RD S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-5368
Practice Address - Country:US
Practice Address - Phone:651-355-9055
Practice Address - Fax:651-355-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1080231-1-HCBS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health