Healthcare Provider Details

I. General information

NPI: 1912219502
Provider Name (Legal Business Name): ELITE NURSING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 MICHAEL ST
EAST HAVEN CT
06513-1861
US

IV. Provider business mailing address

73 MICHAEL ST
EAST HAVEN CT
06513-1861
US

V. Phone/Fax

Practice location:
  • Phone: 203-710-9662
  • Fax: 203-469-1827
Mailing address:
  • Phone: 203-710-9662
  • Fax: 203-469-1827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA ANN SIMONELLI
Title or Position: OWNER/DIRECTOR
Credential: NURSE
Phone: 203-710-9662