MEDICARE: ELITE CARE GH 1 LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1215868682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE CARE GH 1 LLC

Provider Business Mailing Address
First Line	:	PO BOX 9525
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-9088
Country	:	US
Telephone Number	:	732-674-5748
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 WATAUGA RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3227
Country	:	US
Telephone Number	:	732-674-5748
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMES FREDERICK
Credential	:
Telephone Number	:	732-674-5748

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

Similar Medicare Providers

1023792256 — LEKAN SAHEED ALAO
Practice Location Address:

1320 SNOWY EGRET DR
FAYETTEVILLE, NC
28306-3227

Practice Phone: 919-522-5335
Practice Fax:

1104501428 — ALPHACRAFT LLC
Practice Location Address:

1320 SNOWY EGRET DR
FAYETTEVILLE, NC
28306-3227

Practice Phone: 919-522-5335
Practice Fax:

1316878937 — CAROLIE ATHERTON, MSW, LCSW
Practice Location Address:

1805 BARNABUS CIR
FAYETTEVILLE, NC
28304-4800

Practice Phone: 910-723-1369
Practice Fax: 910-310-2235

1477178937 — JEAN YI
Practice Location Address:

2907 DARK BRANCH RD
FAYETTEVILLE, NC
28304-3718

Practice Phone: 718-316-5358
Practice Fax:

1053074427 — BHARATHAN RADHAKRISHNAN
Practice Location Address:

1638 OWEN DR
FAYETTEVILLE, NC
28304-3424

Practice Phone: 910-615-4000
Practice Fax:

1275536815 — DAVID JAMES ALLISON M.D.
Practice Location Address:

3186 VILLAGE DR STE 201
FAYETTEVILLE, NC
28304-3979

Practice Phone: 910-486-5700
Practice Fax: 910-486-5950

Directions to “ELITE CARE GH 1 LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.