Healthcare Provider Details

I. General information

NPI: 1811442106
Provider Name (Legal Business Name): ELITE MEDICAL STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44450 PINETREE DR SUITE 203
PLYMOUTH MI
48170-3869
US

IV. Provider business mailing address

44450 PINETREE DR SUITE 203
PLYMOUTH MI
48170-3869
US

V. Phone/Fax

Practice location:
  • Phone: 734-207-8316
  • Fax:
Mailing address:
  • Phone: 734-207-8316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DENISE K COOK
Title or Position: AREA DIRECTOR
Credential:
Phone: 734-207-8316