Provider Demographics
NPI:1144763137
Name:ELLIOTT ENTERPRISE AND HOLDINGS
Entity type:Organization
Organization Name:ELLIOTT ENTERPRISE AND HOLDINGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANG
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MBA
Authorized Official - Phone:682-777-5299
Mailing Address - Street 1:1751 HIDDEN BLUFF TRL APT 1125
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2623
Mailing Address - Country:US
Mailing Address - Phone:682-777-5299
Mailing Address - Fax:
Practice Address - Street 1:1751 HIDDEN BLUFF TRL APT 1125
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2623
Practice Address - Country:US
Practice Address - Phone:682-777-5299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health