Provider Demographics
NPI:1528418829
Name:FLORIDA LIMITED LIABILITY COMPANY ELITE FOSTER CARE, LLC
Entity Type:Organization
Organization Name:FLORIDA LIMITED LIABILITY COMPANY ELITE FOSTER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-635-8315
Mailing Address - Street 1:3840 HAMILTON KY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7400
Mailing Address - Country:US
Mailing Address - Phone:561-635-8315
Mailing Address - Fax:
Practice Address - Street 1:11682 ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-9133
Practice Address - Country:US
Practice Address - Phone:561-635-8315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, ChildGroup - Single Specialty