Healthcare Provider Details

I. General information

NPI: 1871959254
Provider Name (Legal Business Name): ELITE HOMEMAKER AND COMPANION SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2016
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 DOUGLAS AVE UNIT 159
ALTAMONTE SPRINGS FL
32714-2097
US

IV. Provider business mailing address

940 DOUGLAS AVE UNIT 159
ALTAMONTE SPRINGS FL
32714-2097
US

V. Phone/Fax

Practice location:
  • Phone: 407-694-2998
  • Fax:
Mailing address:
  • Phone: 407-694-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SIGFRED MARQUEZ
Title or Position: CEO
Credential: RN
Phone: 407-694-2998