Provider Demographics
NPI:1982849584
Name:ELITA 7, LLC
Entity Type:Organization
Organization Name:ELITA 7, LLC
Other - Org Name:DONNA KAY REST HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DASHEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-755-6667
Mailing Address - Street 1:16 MARBLE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603
Mailing Address - Country:US
Mailing Address - Phone:508-755-6667
Mailing Address - Fax:
Practice Address - Street 1:16 MARBLE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603
Practice Address - Country:US
Practice Address - Phone:508-755-6667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility