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ELEANOR HEALTH PROFESSIONAL WA, PLLC

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Company Details

Legal Name: ELEANOR HEALTH PROFESSIONAL WA, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: September 17th 2020
Expiration date: 30 Sep 2025
UBI Number: 604 535 799
Home State: MASSACHUSETTS
Principal Office Street Address: Google Maps Logo 221 CRESCENT ST STE 202, WALTHAM, MA, 02453-3425, UNITED STATES

Contact Details

E-Mail: CLS-CTARMSEVIDENCE@WOLTERSKLUWER.COM

Nature of Business

Health Care, Social Assistance & Service Organization, SUD AND ADDICTION TREATMENT

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Registered Agent Information

Name Role
C T CORPORATION SYSTEM Registered Agent

Key Officers & Management

Name Role Address
VIKRAM BAKHRU Executor 8605 SANTA MONICA BLVD # 68379, W HOLLYWOOD, CA, 90069-4109, UNITED STATES
NZINGA HARRISON Governing Person -

National Provider Identifier

NPI Number:
1043827132
Certification Date:
2025-03-24

Authorized Person:

Name:
NZINGA AJABU HARRISON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
207QA0401X - Addiction Medicine (Family Medicine) Physician
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
2084P0802X - Addiction Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician
Is Primary:
Yes

Contacts:

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