Provider Demographics
NPI:1225548688
Name:ELITE HOME CAREGIVERS, LLC.
Entity Type:Organization
Organization Name:ELITE HOME CAREGIVERS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-862-5933
Mailing Address - Street 1:207 LILLIBRIDGE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-1516
Mailing Address - Country:US
Mailing Address - Phone:570-862-5933
Mailing Address - Fax:
Practice Address - Street 1:207 LILLIBRIDGE ST APT 1
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-1516
Practice Address - Country:US
Practice Address - Phone:570-862-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA34833601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health