Healthcare Provider Details

I. General information

NPI: 1518732007
Provider Name (Legal Business Name): ELITE HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E MAIN ST
BRIDGEPORT CT
06608-1419
US

IV. Provider business mailing address

1400 E MAIN ST
BRIDGEPORT CT
06608-1419
US

V. Phone/Fax

Practice location:
  • Phone: 203-747-5011
  • Fax: 475-302-3711
Mailing address:
  • Phone: 203-747-5011
  • Fax: 475-302-3711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA MARTINEZ-MELLOW
Title or Position: OWNER
Credential:
Phone: 203-747-5011