Provider Demographics
NPI:1174127500
Name:ELNORA HOME HEALTH AGENCY, LLC
Entity type:Organization
Organization Name:ELNORA HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REKIAT
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAYIWOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-402-9945
Mailing Address - Street 1:5311 NORTHFIELD RD STE 410
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1135
Mailing Address - Country:US
Mailing Address - Phone:216-402-9945
Mailing Address - Fax:
Practice Address - Street 1:5311 NORTHFIELD RD STE 410
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1135
Practice Address - Country:US
Practice Address - Phone:216-402-9945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1831359OtherDODD
OH0323707Medicaid