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Organization

ELOHIM HOME LLC

Active
Other names
Elohim home LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NITEZEHO NKUNDABERA NIYOMUGABO (PRESIDENT/CEO)
(515) 721-6114
Entity
Organization

Contact information

Practice address
700 NE ALICES RD APT 2, WAUKEE, IA 50263-8853
(515) 721-6114
(515) 257-7674
Mailing address
2815 100TH ST # 386, URBANDALE, IA 50322-3860
(515) 639-4628
(515) 257-7674

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
251E00000X
Home Health Agency
251G00000X
Community Based Hospice Care Agency
251S00000X
Community/Behavioral Health Agency
Primary
253J00000X
Foster Care Agency
253Z00000X
In Home Supportive Care Agency
282J00000X
Religious Nonmedical Health Care Institution
3245S0500X
Children's Substance Abuse Rehabilitation Facility
343900000X
Non-emergency Medical Transport (VAN)
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
08/08/2024
Last updated
08/08/2024
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