Provider Demographics
NPI:1457028961
Name:ELITE CONNECT HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:ELITE CONNECT HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES VAN
Authorized Official - Middle Name:SUN
Authorized Official - Last Name:CORPUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-728-1461
Mailing Address - Street 1:1801 MURCHISON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4518
Mailing Address - Country:US
Mailing Address - Phone:415-728-1461
Mailing Address - Fax:
Practice Address - Street 1:1801 MURCHISON DR STE 200
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4518
Practice Address - Country:US
Practice Address - Phone:415-728-1461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based