Provider Demographics
NPI:1760198378
Name:ELITE CARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ELITE CARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTRANGELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-505-3623
Mailing Address - Street 1:250 W 80TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5430
Mailing Address - Country:US
Mailing Address - Phone:219-648-2125
Mailing Address - Fax:219-472-8468
Practice Address - Street 1:250 W 80TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5430
Practice Address - Country:US
Practice Address - Phone:219-648-2125
Practice Address - Fax:219-472-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care