Provider Demographics
NPI:1568846798
Name:YOUR ELITE COMPANION SITTING AND HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:YOUR ELITE COMPANION SITTING AND HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CORNELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN-CEO
Authorized Official - Phone:404-781-5130
Mailing Address - Street 1:3163 DOVE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3652
Mailing Address - Country:US
Mailing Address - Phone:770-875-9234
Mailing Address - Fax:
Practice Address - Street 1:3235 SATELLITE BLVD
Practice Address - Street 2:BLDG 400 SUITE 300
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8687
Practice Address - Country:US
Practice Address - Phone:770-875-9234
Practice Address - Fax:678-253-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-1275313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility