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General NPI Number Information
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NPI Number | 1154129674
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Entity Type | Organization
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Legal Business Name | ELITE STAIRS ,RAILS, & TRIMWORK INC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 4375 US HIGHWAY 17 STE 103
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4832
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Country | US
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Telephone | 904-269-0886
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Fax | 904-269-0886
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Provider Business Mailing Address
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Address Line | 203 DOLPHIN CIR
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City | MIDDLEBURG
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State | FL
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Zip | 32068-4717
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Country | US
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Telephone | 904-504-7370
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TINA LANGFORD BAILES
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Credential | LMHC
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Telephone | 904-504-7370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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