Healthcare Provider Details

I. General information

NPI: 1629947015
Provider Name (Legal Business Name): E.L.I.T.E. LOVE CARE (EXCEPTIONAL LOVING IN-HOME TRUSTED EXPERTS),LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

728 HOLLANDALE RD
LA VERGNE TN
37086-2003
US

IV. Provider business mailing address

728 HOLLANDALE RD
LA VERGNE TN
37086-2003
US

V. Phone/Fax

Practice location:
  • Phone: 615-200-8731
  • Fax: 615-907-4871
Mailing address:
  • Phone: 615-200-8731
  • Fax: 615-907-4871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: QIANA KINZER-SEATON
Title or Position: OWNER
Credential:
Phone: 615-200-8731