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General NPI Number Information
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NPI Number | 1003294851
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Entity Type | Organization
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Legal Business Name | ELITE HOME CARE
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 2000 BUD ARTHUR BRIDGE RD
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City | SPARTANBURG
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State | SC
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Zip | 29307-4417
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Country | US
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Telephone | 864-580-6477
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1181
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City | SPARTANBURG
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State | SC
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Zip | 29304-1181
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Country | US
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Telephone | 864-869-8739
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Fax | 704-919-5011
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM ANDREW MARTIN
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Credential |
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Telephone | 864-869-8730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | IHCP-0030
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License Number State | SC
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