Elcm Johnson City Leasing LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

ACL0000000376 Issued in TN

Legal business name

ELCM JOHNSON CITY LEASING LLC

Practice address

2111 E Lakeview Dr
Johnson City, TN 37601-1890

Phone

(423) 926-1292

NPI assigned

Aug 26, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul Boethel

Title

Principal

Phone

(214) 535-6071

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1366998718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14241 DALLAS PKWY",
            "address_2": "SUITE 650, BUILDING 3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E LAKEVIEW DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011890",
            "telephone_number": "423-926-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELCM JOHNSON CITY LEASING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "BOETHEL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "214-535-6071"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "TN",
            "license": "ACL0000000376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Michelle Ekstrom, M.S., CCC-SLP
• Hana El Ado Mikdachi, M.D.
• Hadi E El Bazouni, MD
• Elaine L. Devos MD PC
• Saravanan Elangovan, PH.D., CCC-A
• Elcm Johnson City Management LLC
• Brad Eldridge, D.C.
• Kennedy L Eldridge, DNP, PMHNP-BC
• Henry Claude Eliacin
• Zaid Elkarmi, MD

• Adult Care Home Facility in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Adult Care Home Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.