Healthcare Provider Details

I. General information

NPI: 1801705140
Provider Name (Legal Business Name): ELITE CHILDREN'S DEVELOPMENT CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 S PIONEER WAY
MOSES LAKE WA
98837-2458
US

IV. Provider business mailing address

1417 S PIONEER WAY
MOSES LAKE WA
98837-2458
US

V. Phone/Fax

Practice location:
  • Phone: 509-855-4141
  • Fax: 509-855-4042
Mailing address:
  • Phone: 509-855-4141
  • Fax: 509-855-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: GRANT L COX
Title or Position: OWNER
Credential:
Phone: 509-855-4141