Provider Demographics
NPI:1306320601
Name:ELIAS ADULT DAY CARE
Entity type:Organization
Organization Name:ELIAS ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WESIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-291-3151
Mailing Address - Street 1:3727 E BROAD ROCK RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-3427
Mailing Address - Country:US
Mailing Address - Phone:804-912-2475
Mailing Address - Fax:804-918-5805
Practice Address - Street 1:3727 E BROAD ROCK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-3427
Practice Address - Country:US
Practice Address - Phone:804-912-2475
Practice Address - Fax:804-918-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherDEPARTMENT OF THE TREASURY INTERNAL REVENUE