Provider Demographics
NPI:1346759925
Name:ELITE HEALTHCARE GROUP INC.
Entity Type:Organization
Organization Name:ELITE HEALTHCARE GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DINKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-997-3325
Mailing Address - Street 1:615 COLISEUM DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5310
Mailing Address - Country:US
Mailing Address - Phone:336-579-3560
Mailing Address - Fax:336-579-3561
Practice Address - Street 1:615 COLISEUM DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5310
Practice Address - Country:US
Practice Address - Phone:336-579-3560
Practice Address - Fax:336-579-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty