Provider Demographics
NPI:1902029515
Name:ELITE HEALTH CARE, INC.
Entity Type:Organization
Organization Name:ELITE HEALTH CARE, INC.
Other - Org Name:ELITE HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-776-5683
Mailing Address - Street 1:7 FAIRLAND CT
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143-1118
Mailing Address - Country:US
Mailing Address - Phone:304-776-5683
Mailing Address - Fax:304-776-5615
Practice Address - Street 1:1832 HARPER RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3366
Practice Address - Country:US
Practice Address - Phone:304-256-0070
Practice Address - Fax:304-256-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0004539000Medicaid
WV517089Medicare ID - Type Unspecified