Healthcare Provider Details

I. General information

NPI: 1972460574
Provider Name (Legal Business Name): ELITE COMPASSIONATE SERVICES OF CA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W FOOTHILL BLVD STE 214
UPLAND CA
91786-8023
US

IV. Provider business mailing address

2108 N ST STE 7568
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 909-741-4884
  • Fax:
Mailing address:
  • Phone: 909-741-4884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MALISHA WARD
Title or Position: PRESIDENT
Credential:
Phone: 909-741-4884