Provider Demographics
NPI:1598454118
Name:ELITE CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ELITE CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKLAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-593-6581
Mailing Address - Street 1:909 MEADOWLARK LN STE 2
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2309
Mailing Address - Country:US
Mailing Address - Phone:615-593-6581
Mailing Address - Fax:484-952-4605
Practice Address - Street 1:909 MEADOWLARK LN STE 2
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2309
Practice Address - Country:US
Practice Address - Phone:615-593-6581
Practice Address - Fax:484-952-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI000000022124OtherDEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITY SERVICES