Provider Demographics
NPI:1619683562
Name:ELITE CARE HCS INC.
Entity Type:Organization
Organization Name:ELITE CARE HCS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-330-5963
Mailing Address - Street 1:5201 MEMORIAL DR UNIT 627
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-8408
Mailing Address - Country:US
Mailing Address - Phone:713-330-5963
Mailing Address - Fax:
Practice Address - Street 1:5201 MEMORIAL DR UNIT 627
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-8408
Practice Address - Country:US
Practice Address - Phone:713-330-5963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD18399961Medicaid