Provider Demographics
NPI:1467110114
Name:ELITE CONCIERGE PRIVATE CARE, LLC
Entity Type:Organization
Organization Name:ELITE CONCIERGE PRIVATE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-240-9289
Mailing Address - Street 1:100 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4306
Mailing Address - Country:US
Mailing Address - Phone:772-672-4256
Mailing Address - Fax:772-672-4915
Practice Address - Street 1:100 S 2ND ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4306
Practice Address - Country:US
Practice Address - Phone:772-672-4256
Practice Address - Fax:772-672-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health