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General NPI Number Information
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NPI Number | 1245813336
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Entity Type | Organization
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Legal Business Name | ELITE HOME HEALTH CARE 2 LLC DBA ELITE HOME HEALTH CARE 2
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 11155 S TOWNE SQ STE B2
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City | SAINT LOUIS
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State | MO
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Zip | 63123-7852
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Country | US
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Telephone | 314-939-1103
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Fax | 314-939-1104
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Provider Business Mailing Address
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Address Line | 11155 S TOWNE SQ UNIT B
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City | SAINT LOUIS
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State | MO
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Zip | 63123-7852
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Country | US
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Telephone | 314-939-1103
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Fax | 314-939-1104
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Authorized Official
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Title or Position | OWNER
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Name | LATICHA VAUGHN
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Credential |
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Telephone | 314-500-3330
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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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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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