Provider Demographics
NPI:1356172811
Name:ELOHIM HOME LLC
Entity type:Organization
Organization Name:ELOHIM HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NITEZEHO
Authorized Official - Middle Name:NKUNDABERA
Authorized Official - Last Name:NIYOMUGABO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-721-6114
Mailing Address - Street 1:2815 100TH ST # 386
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3860
Mailing Address - Country:US
Mailing Address - Phone:515-639-4628
Mailing Address - Fax:515-257-7674
Practice Address - Street 1:700 NE ALICES RD APT 2
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8853
Practice Address - Country:US
Practice Address - Phone:515-721-6114
Practice Address - Fax:515-257-7674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child