Healthcare Provider Details

I. General information

NPI: 1811508500
Provider Name (Legal Business Name): C&B ELITE CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 MIRAMAR PKWY STE 113
MIRAMAR FL
33023-3987
US

IV. Provider business mailing address

16309 SW 15TH ST
PEMBROKE PINES FL
33027-5129
US

V. Phone/Fax

Practice location:
  • Phone: 954-496-2112
  • Fax:
Mailing address:
  • Phone: 954-496-2112
  • Fax:

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: CLAUDETTE M JOHNSON
Title or Position: PRESIDENT
Credential: HEALTH SERVICES ADMI
Phone: 954-496-2112