Provider Demographics
NPI:1760299648
Name:ELIJEKO CARE GROUP, LLC
Entity type:Organization
Organization Name:ELIJEKO CARE GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREWS
Authorized Official - Middle Name:KWABENA
Authorized Official - Last Name:NYANTAKYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-200-6933
Mailing Address - Street 1:1209 N EAST ST STE A203
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4662
Mailing Address - Country:US
Mailing Address - Phone:952-200-6933
Mailing Address - Fax:
Practice Address - Street 1:1209 N EAST ST STE A
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4662
Practice Address - Country:US
Practice Address - Phone:952-200-6933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care