| NPI | 1235252826 |
|---|---|
| Doing Business As | ELLENDEL ISL |
| Entity Type | Organization |
| Authorized Contact | RHODA ELLEN TOMICH Owner/Manager 660-627-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2022-11-25 |