Provider Demographics
NPI:1841720570
Name:ELDORADO HEALTHCARE MANAGEMENT, LLC
Entity type:Organization
Organization Name:ELDORADO HEALTHCARE MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKHAKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-704-7337
Mailing Address - Street 1:4991 CORLISS RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1130
Mailing Address - Country:US
Mailing Address - Phone:216-704-7337
Mailing Address - Fax:
Practice Address - Street 1:325 ALPHA PARK
Practice Address - Street 2:
Practice Address - City:HIGHLAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2237
Practice Address - Country:US
Practice Address - Phone:217-704-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health