Provider Demographics
NPI:1427389154
Name:ELITE HOME NURSING SERVICES, LLC
Entity Type:Organization
Organization Name:ELITE HOME NURSING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDDENA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-416-1640
Mailing Address - Street 1:45175 CARR RD
Mailing Address - Street 2:
Mailing Address - City:COOLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45723-9552
Mailing Address - Country:US
Mailing Address - Phone:740-416-1640
Mailing Address - Fax:
Practice Address - Street 1:45175 CARR RD
Practice Address - Street 2:
Practice Address - City:COOLVILLE
Practice Address - State:OH
Practice Address - Zip Code:45723-9552
Practice Address - Country:US
Practice Address - Phone:740-416-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health