Healthcare Provider Details

I. General information

NPI: 1619704483
Provider Name (Legal Business Name): ELITE HOMECARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9540 WOODLAND HILLS DR
WEST CHESTER OH
45011-9311
US

IV. Provider business mailing address

9540 WOODLAND HILLS DR
WEST CHESTER OH
45011-9311
US

V. Phone/Fax

Practice location:
  • Phone: 484-347-9523
  • Fax:
Mailing address:
  • Phone: 484-347-9523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. FLORENCE E. ESI JONFIAH
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 484-347-9523