MEDICARE: ELITE HOME HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194307025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE HOME HEALTH, PLLC

Provider Business Mailing Address
First Line	:	4100 E PIEDRAS DR STE 245
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1426
Country	:	US
Telephone Number	:	210-294-0742
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 E PIEDRAS DR STE 245
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1426
Country	:	US
Telephone Number	:	210-294-0742
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	ALYSON MASSINGILL
Credential	:
Telephone Number	:	210-294-0742

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	04/21/2021

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Directions to “ELITE HOME HEALTH, PLLC ” Practice Location

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