Healthcare Provider Details

I. General information

NPI: 1154599801
Provider Name (Legal Business Name): ELITE CARE NURSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 S AMHERST HWY
MADISON HEIGHTS VA
24572-2490
US

IV. Provider business mailing address

5005 S AMHERST HWY
MADISON HEIGHTS VA
24572-2490
US

V. Phone/Fax

Practice location:
  • Phone: 434-846-1514
  • Fax:
Mailing address:
  • Phone: 434-846-1514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA JEAN MILLER
Title or Position: OWNER
Credential:
Phone: 434-846-1514