Provider Demographics
NPI:1720076482
Name:ELIM HOMES, INC.
Entity Type:Organization
Organization Name:ELIM HOMES, INC.
Other - Org Name:ELIM REHAB & CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SEELOCHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:STADTHERR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-855-5041
Mailing Address - Street 1:3534 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6228
Mailing Address - Country:US
Mailing Address - Phone:701-271-1803
Mailing Address - Fax:701-271-1846
Practice Address - Street 1:3534 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-6228
Practice Address - Country:US
Practice Address - Phone:701-271-1803
Practice Address - Fax:701-271-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1021A314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND030051Medicaid
MN417226400Medicaid
ND1021AOtherNORTH DAKOTA STATE LICENS