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General NPI Number Information
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NPI Number | 1255149860
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Entity Type | Organization
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Legal Business Name | ELITE HOME CARE DAY CARE AND TRAINING
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Dates
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Enumeration Date | 12/28/2024
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 16004 BROADWAY AVE
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City | MAPLE HEIGHTS
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State | OH
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Zip | 44137-2575
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Country | US
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Telephone | 216-269-1487
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Fax |
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Provider Business Mailing Address
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Address Line | 13314 CRANWOOD DR
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44105-6812
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOO
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Name | AMY POTILLO
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Credential |
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Telephone | 216-269-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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