Healthcare Provider Details

I. General information

NPI: 1588116792
Provider Name (Legal Business Name): ELITE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W 2ND AVE
FRANKLIN VA
23851-1711
US

IV. Provider business mailing address

115 W 2ND AVE
FRANKLIN VA
23851-1711
US

V. Phone/Fax

Practice location:
  • Phone: 757-562-2000
  • Fax: 866-814-4876
Mailing address:
  • Phone: 757-562-2000
  • Fax: 866-814-4876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-171484
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHCO-171484
License Number StateVA

VIII. Authorized Official

Name: HENRY OLDS
Title or Position: CEO
Credential:
Phone: 757-651-8765