Provider Demographics
NPI:1275957060
Name:ELITE HEALTHCARE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:ELITE HEALTHCARE ENTERPRISES, INC.
Other - Org Name:ELITE HOSPICE OF BUCKHEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-855-4597
Mailing Address - Street 1:92 W PACES FERRY RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1351
Mailing Address - Country:US
Mailing Address - Phone:404-855-4597
Mailing Address - Fax:
Practice Address - Street 1:92 W PACES FERRY RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1351
Practice Address - Country:US
Practice Address - Phone:404-855-4597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based