Healthcare Provider Details

I. General information

NPI: 1093446411
Provider Name (Legal Business Name): ANNOLIVER ELITE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 INDIANA AVE
MONESSEN PA
15062-1610
US

IV. Provider business mailing address

4607 LIBRARY RD STE 220
BETHEL PARK PA
15102-6909
US

V. Phone/Fax

Practice location:
  • Phone: 412-759-6695
  • Fax:
Mailing address:
  • Phone: 412-759-6695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NIKKIA L JONES
Title or Position: CEO
Credential:
Phone: 412-347-2402