Healthcare Provider Details

I. General information

NPI: 1467834184
Provider Name (Legal Business Name): ELITE TOO HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 CHURCH ST N SUITE 280-J
CONCORD NC
28025-4589
US

IV. Provider business mailing address

363 CHURCH ST N SUITE 280-J
CONCORD NC
28025-4589
US

V. Phone/Fax

Practice location:
  • Phone: 704-222-9834
  • Fax:
Mailing address:
  • Phone: 704-222-9834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC3246
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHC3246
License Number StateNC

VIII. Authorized Official

Name: TARA ELLERBE
Title or Position: PRESIDENT
Credential:
Phone: 704-222-9834