Healthcare Provider Details

I. General information

NPI: 1134540040
Provider Name (Legal Business Name): ELITE ADULT DAY AND WELLNESS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 22ND AVE N
NASHVILLE TN
37203-1801
US

IV. Provider business mailing address

209 22ND AVE N
NASHVILLE TN
37203-1801
US

V. Phone/Fax

Practice location:
  • Phone: 818-388-8141
  • Fax: 818-757-0903
Mailing address:
  • Phone: 818-388-8141
  • Fax: 818-757-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEONID UCHENIK
Title or Position: PRESIDENT
Credential:
Phone: 818-388-8141