Provider Demographics
NPI:1689308702
Name:ELITE CARE AGENCY INC
Entity Type:Organization
Organization Name:ELITE CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:JUUKO
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:857-247-0576
Mailing Address - Street 1:320 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-3408
Mailing Address - Country:US
Mailing Address - Phone:857-247-0576
Mailing Address - Fax:
Practice Address - Street 1:320 ADAMS ST
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3408
Practice Address - Country:US
Practice Address - Phone:857-247-0576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility