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General NPI Number Information
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NPI Number | 1205067956
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Entity Type | Organization
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Legal Business Name | ELITE CHOICE HOME CARE
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 2155 CORTE VIS 114
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City | CHULA VISTA
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State | CA
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Zip | 91915-4120
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Country | US
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Telephone | 619-316-3375
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Fax | 619-934-8663
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Provider Business Mailing Address
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Address Line | PO BOX 211663
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City | CHULA VISTA
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State | CA
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Zip | 91921-1663
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Country | US
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Telephone | 619-316-3375
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Fax | 619-934-8663
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Authorized Official
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Title or Position | OWNER
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Name | HELEN MARIANNE BASTEN
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Credential | LVN
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Telephone | 619-316-3375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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