Healthcare Provider Details

I. General information

NPI: 1043602907
Provider Name (Legal Business Name): ELITE HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3649 LEE RD
SHAKER HEIGHTS OH
44120-5108
US

IV. Provider business mailing address

3649 LEE RD
SHAKER HEIGHTS OH
44120-5108
US

V. Phone/Fax

Practice location:
  • Phone: 216-336-5608
  • Fax: 216-245-6805
Mailing address:
  • Phone: 216-336-5608
  • Fax: 216-245-6805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number401620330314
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. AMY LYNNE GARDNER
Title or Position: EXECUTIVE DIRECTOR/CEO
Credential: MBA
Phone: 216-336-5608