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General NPI Number Information
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NPI Number | 1689308702
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Entity Type | Organization
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Legal Business Name | ELITE CARE AGENCY INC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 320 ADAMS ST
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City | AGAWAM
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State | MA
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Zip | 01001-3408
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Country | US
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Telephone | 857-247-0576
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Fax |
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Provider Business Mailing Address
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Address Line | 320 ADAMS ST
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City | AGAWAM
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State | MA
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Zip | 01001-3408
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Country | US
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Telephone | 857-247-0576
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RONALD JUUKO
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Credential | RN BSN
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Telephone | 857-247-0576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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