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General NPI Number Information
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NPI Number | 1518820307
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Entity Type | Organization
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Legal Business Name | ELITE PERSONAL CARE SOLUTIONS LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1690 WATERTOWER PL STE 100
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City | EAST LANSING
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State | MI
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Zip | 48823-8045
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Country | US
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Telephone | 912-744-9276
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Fax | 912-724-7219
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Provider Business Mailing Address
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Address Line | 915 GOOGE ST
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City | SAVANNAH
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State | GA
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Zip | 31415-3168
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Country | US
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Telephone | 912-744-9276
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Fax | 912-742-7219
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TERRANCE K LUCKY II
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Credential | PHD.CC.MHT.CTI
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Telephone | 912-744-9276
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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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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #6
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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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