Provider Demographics
NPI:1942307590
Name:ELITE OF CARE SERVICES, INC
Entity Type:Organization
Organization Name:ELITE OF CARE SERVICES, INC
Other - Org Name:OAKFIELD HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:AULEASE
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:313-384-0790
Mailing Address - Street 1:15442 OAKFIELD ST
Mailing Address - Street 2:P.O.BOX 32988
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-1534
Mailing Address - Country:US
Mailing Address - Phone:313-659-9030
Mailing Address - Fax:313-271-8411
Practice Address - Street 1:15442 OAKFIELD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-1534
Practice Address - Country:US
Practice Address - Phone:313-659-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI305R00000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization
Not Answered320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities