Provider Demographics
NPI:1144044892
Name:CONNECT INTEGRATED HEALTH SERVICES LLC.
Entity type:Organization
Organization Name:CONNECT INTEGRATED HEALTH SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-713-7479
Mailing Address - Street 1:6925 IRONBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-9500
Mailing Address - Country:US
Mailing Address - Phone:240-713-7479
Mailing Address - Fax:
Practice Address - Street 1:6925 IRONBRIDGE LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-9500
Practice Address - Country:US
Practice Address - Phone:240-713-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty