Provider Demographics
NPI:1992965511
Name:J.ELOHIM INC
Entity type:Organization
Organization Name:J.ELOHIM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:N
Authorized Official - Last Name:SACKEYT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-744-1921
Mailing Address - Street 1:1435 WINDMILL HILL LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-4130
Mailing Address - Country:US
Mailing Address - Phone:469-744-1921
Mailing Address - Fax:
Practice Address - Street 1:1435 WINDMILL HILL LN
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4130
Practice Address - Country:US
Practice Address - Phone:469-744-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health