Provider Demographics
NPI:1912219502
Name:ELITE NURSING CARE
Entity Type:Organization
Organization Name:ELITE NURSING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SIMONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:203-710-9662
Mailing Address - Street 1:73 MICHAEL ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-1861
Mailing Address - Country:US
Mailing Address - Phone:203-710-9662
Mailing Address - Fax:203-469-1827
Practice Address - Street 1:73 MICHAEL ST
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-1861
Practice Address - Country:US
Practice Address - Phone:203-710-9662
Practice Address - Fax:203-469-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care