Healthcare Provider Details

I. General information

NPI: 1518820307
Provider Name (Legal Business Name): ELITE PERSONAL CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 WATERTOWER PL STE 100
EAST LANSING MI
48823-8045
US

IV. Provider business mailing address

915 GOOGE ST
SAVANNAH GA
31415-3168
US

V. Phone/Fax

Practice location:
  • Phone: 912-744-9276
  • Fax: 912-724-7219
Mailing address:
  • Phone: 912-744-9276
  • Fax: 912-742-7219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRANCE K LUCKY II
Title or Position: DIRECTOR
Credential: PHD.CC.MHT.CTI
Phone: 912-744-9276