Healthcare Provider Details

I. General information

NPI: 1023912938
Provider Name (Legal Business Name): ELITE HOME CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 OAK ST
NILES MI
49120-3737
US

IV. Provider business mailing address

51693 WATERFORD LN
GRANGER IN
46530-7610
US

V. Phone/Fax

Practice location:
  • Phone: 574-386-2090
  • Fax:
Mailing address:
  • Phone: 574-386-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMES NJUGUNA
Title or Position: OWNER
Credential:
Phone: 574-386-2090