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General NPI Number Information
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NPI Number | 1629702519
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Entity Type | Organization
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Legal Business Name | ELITE WELLNESS, LLP
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 19 BELMONT RD
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3910
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Country | US
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Telephone | 203-927-2191
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Fax | 325-221-2031
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Provider Business Mailing Address
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Address Line | 19 BELMONT RD
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3910
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Country | US
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Telephone | 203-927-2191
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | MS. JENNIFER B LEE
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Credential | APRN
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Telephone | 203-927-2191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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