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General NPI Number Information
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NPI Number | 1770955379
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Entity Type | Organization
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Legal Business Name | ELITE HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 157 INMAN CT
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City | BEDFORD
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State | IN
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Zip | 47421-9628
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Country | US
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Telephone | 812-278-4373
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1105
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City | BEDFORD
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State | IN
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Zip | 47421-1105
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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 | MEMBER
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Name | WILLIAM DECKARD
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Credential |
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Telephone | 812-278-4373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 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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