Provider Demographics
NPI:1750787578
Name:ELLIS BUSINESS GROUP LLC.
Entity type:Organization
Organization Name:ELLIS BUSINESS GROUP LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATARSHA
Authorized Official - Middle Name:NECOLE
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-968-7162
Mailing Address - Street 1:3360 CLEARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-4572
Mailing Address - Country:US
Mailing Address - Phone:281-968-7162
Mailing Address - Fax:281-968-7162
Practice Address - Street 1:3360 CLEARWOOD CIR
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-4572
Practice Address - Country:US
Practice Address - Phone:281-968-7162
Practice Address - Fax:281-968-7162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01570253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care