Provider Demographics
NPI:1558799304
Name:ELITE HOME HEALTH LLC
Entity Type:Organization
Organization Name:ELITE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:LAVON
Authorized Official - Last Name:GROOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-554-1890
Mailing Address - Street 1:841 PRUDENTIAL DR
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8329
Mailing Address - Country:US
Mailing Address - Phone:904-371-1959
Mailing Address - Fax:904-371-1901
Practice Address - Street 1:841 PRUDENTIAL DR
Practice Address - Street 2:12TH FLOOR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8329
Practice Address - Country:US
Practice Address - Phone:904-371-1959
Practice Address - Fax:904-371-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health