MEDICARE: ELITE TRANSITIONAL SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1801333299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE TRANSITIONAL SERVICES LLC

Provider Business Mailing Address
First Line	:	1730 SECTION RD
Second Line	:	1038
City	:	CINCINNATI
State	:	OH
Zip	:	45222-7500
Country	:	US
Telephone Number	:	513-386-9032
Fax Number	:	844-224-1064

Provider Business Practice Location Address
First Line	:	1 N COMMERCE PARK DR
Second Line	:	SUITE 310
City	:	CINCINNATI
State	:	OH
Zip	:	45215-3187
Country	:	US
Telephone Number	:	513-386-9032
Fax Number	:	844-224-1064

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	FELICISA DANGERFIELD
Credential	:	MSW CDCA
Telephone Number	:	513-386-9032

Provider Enumeration Date	:	01/24/2017
Last Update Date	:	01/24/2017

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