Provider Demographics
NPI:1578270054
Name:ELITE CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ELITE CARE SERVICES, LLC
Other - Org Name:ELITE CARE SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-854-8151
Mailing Address - Street 1:8700 BUCKINGHAM LN
Mailing Address - Street 2:#14
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-1236
Mailing Address - Country:US
Mailing Address - Phone:816-263-8290
Mailing Address - Fax:
Practice Address - Street 1:8700 BUCKINGHAM LN APT 14
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-1236
Practice Address - Country:US
Practice Address - Phone:808-854-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO02Medicaid