MEDICARE: ELITE COMPANION AND HOMEMAKER 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	253Z00000X	In Home Supportive Care Agency	232505	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	232505	OTHER	FL	AHCA LICENSE NUMBER

General Provider Information

NPI Number	:	1871854216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE COMPANION AND HOMEMAKER SERVICES, LLC

Provider Business Mailing Address
First Line	:	3760 N JOG RD
Second Line	:	SUITE 103
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-7452
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3760 N JOG RD
Second Line	:	SUITE 103
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-7452
Country	:	US
Telephone Number	:	561-713-8970
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SHARDA PARAHOO
Credential	:
Telephone Number	:	561-713-8970

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	06/01/2012

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