Healthcare Provider Details

I. General information

NPI: 1770492670
Provider Name (Legal Business Name): ELITECARE HEALTHSERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2806 E 4TH ST
WATERLOO IA
50703-2013
US

IV. Provider business mailing address

6602 DEKEON DR
ATLANTA GA
30349-8862
US

V. Phone/Fax

Practice location:
  • Phone: 404-883-1575
  • Fax: 504-569-5753
Mailing address:
  • Phone: 404-883-1575
  • Fax: 504-569-5753

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAKITA HEALTHSERVICES LLC-G RUSHING
Title or Position: ADMINISTRATI DIRECTOR
Credential:
Phone: 404-883-1575