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General NPI Number Information
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NPI Number | 1497908107
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Entity Type | Organization
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Legal Business Name | ELITE HEALTH AGENCY, INC.
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Dates
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Enumeration Date | 10/25/2008
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Last Update Date | 10/25/2008
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Provider Practice Location Address
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Address Line | 2409 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5123
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Country | US
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Telephone | 954-825-0309
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Fax | 954-825-0310
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Provider Business Mailing Address
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Address Line | 2409 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5123
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Country | US
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Telephone | 954-825-0309
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Fax | 954-825-0310
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MS. ESTELLE DOUGLAS
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Credential | R.N.
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Telephone | 954-562-6939
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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 | 299992544
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License Number State | FL
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