Healthcare Provider Details

I. General information

NPI: 1043145303
Provider Name (Legal Business Name): ELITE VETERANS LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 SOMERVILLE DR S
LAKELAND FL
33815-3973
US

IV. Provider business mailing address

9648 US HIGHWAY 301 S # 113
RIVERVIEW FL
33578-5442
US

V. Phone/Fax

Practice location:
  • Phone: 863-427-5550
  • Fax:
Mailing address:
  • Phone: 863-427-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BELL
Title or Position: OWNER
Credential:
Phone: 813-337-8636