Provider Demographics
NPI:1275281388
Name:ELITE HOME REHAB SERVICES LLC
Entity Type:Organization
Organization Name:ELITE HOME REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYLWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ-PAPARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-827-7945
Mailing Address - Street 1:772 JACQUELINE CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5695
Mailing Address - Country:US
Mailing Address - Phone:347-827-7945
Mailing Address - Fax:609-901-3544
Practice Address - Street 1:155 WILLOWBROOK BLVD
Practice Address - Street 2:STE 110 #2273
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:732-232-5795
Practice Address - Fax:609-901-3544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty