Provider Demographics
NPI:1568295418
Name:ELROI MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:ELROI MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NJEI
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:302-724-1181
Mailing Address - Street 1:8323 OLD FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1913
Mailing Address - Country:US
Mailing Address - Phone:302-724-1181
Mailing Address - Fax:
Practice Address - Street 1:3401 1/2 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2502
Practice Address - Country:US
Practice Address - Phone:302-724-1181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty