Provider Demographics
NPI:1952792517
Name:ELEMENT CARE GROUP
Entity Type:Organization
Organization Name:ELEMENT CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-333-2274
Mailing Address - Street 1:1810 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GARRETT
Mailing Address - State:IN
Mailing Address - Zip Code:46738-1865
Mailing Address - Country:US
Mailing Address - Phone:260-333-2274
Mailing Address - Fax:
Practice Address - Street 1:1810 WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:GARRETT
Practice Address - State:IN
Practice Address - Zip Code:46738-1865
Practice Address - Country:US
Practice Address - Phone:260-333-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003735A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty