Provider Demographics
NPI:1356011639
Name:COMMUNITY CARE ELITE SERVICES
Entity Type:Organization
Organization Name:COMMUNITY CARE ELITE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:I
Authorized Official - Credentials:NP
Authorized Official - Phone:516-960-8629
Mailing Address - Street 1:36 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-5542
Mailing Address - Country:US
Mailing Address - Phone:516-960-8629
Mailing Address - Fax:516-280-3121
Practice Address - Street 1:36 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5542
Practice Address - Country:US
Practice Address - Phone:516-960-8629
Practice Address - Fax:516-280-3121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory