Healthcare Provider Details

I. General information

NPI: 1780512806
Provider Name (Legal Business Name): ELITE CARE HOME HEALTH AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 E HIGHWAY 50 STE 207
CLERMONT FL
34711-5035
US

IV. Provider business mailing address

1635 E HIGHWAY 50 STE 207
CLERMONT FL
34711-5035
US

V. Phone/Fax

Practice location:
  • Phone: 407-205-1989
  • Fax:
Mailing address:
  • Phone: 407-205-1989
  • Fax: 407-517-4384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIE MICKAELLE AUGUSTE
Title or Position: OWNER/ FINANCIAL OFFICER
Credential:
Phone: 407-205-1989