Provider Demographics
NPI:1982049078
Name:ELLI-CARE HEALTH SUPPORT
Entity Type:Organization
Organization Name:ELLI-CARE HEALTH SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSARHIEMEN
Authorized Official - Middle Name:PRINCE
Authorized Official - Last Name:OVIAWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-474-0282
Mailing Address - Street 1:8307 VINY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5485
Mailing Address - Country:US
Mailing Address - Phone:713-474-0282
Mailing Address - Fax:
Practice Address - Street 1:8307 VINY RIDGE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5485
Practice Address - Country:US
Practice Address - Phone:713-474-0282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No253J00000XAgenciesFoster Care AgencyGroup - Multi-Specialty