Provider Demographics
NPI:1083321087
Name:ELITESERVICES HOMECARE
Entity Type:Organization
Organization Name:ELITESERVICES HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AISATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:DIALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-612-2408
Mailing Address - Street 1:88 EDRIS LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-7816
Mailing Address - Country:US
Mailing Address - Phone:678-612-2408
Mailing Address - Fax:
Practice Address - Street 1:88 EDRIS LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-7816
Practice Address - Country:US
Practice Address - Phone:678-612-2408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care