MEDICARE: ELITE HEALTH AND WELLNESS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	385H00000X	Respite Care
4	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720679632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE HEALTH AND WELLNESS INC.

Provider Business Mailing Address
First Line	:	3710 SHANNON RD # 51393
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-6327
Country	:	US
Telephone Number	:	919-667-7707
Fax Number	:

Provider Business Practice Location Address
First Line	:	5317 HIGHGATE DR STE 116
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-6622
Country	:	US
Telephone Number	:	919-251-9472
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SHAKEEMA PRIESTER
Credential	:
Telephone Number	:	919-225-9447

Provider Enumeration Date	:	02/02/2021
Last Update Date	:	01/25/2023

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