Provider Demographics
NPI:1902228166
Name:ELITE HOME HEALTH CARE
Entity Type:Organization
Organization Name:ELITE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLERBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-819-7631
Mailing Address - Street 1:312 N MYERS ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3041
Mailing Address - Country:US
Mailing Address - Phone:980-819-7631
Mailing Address - Fax:980-201-9344
Practice Address - Street 1:312 N MYERS ST
Practice Address - Street 2:SUITE 111
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3041
Practice Address - Country:US
Practice Address - Phone:980-819-7631
Practice Address - Fax:980-201-9344
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELITE HOME HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-07
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care