Provider Demographics
NPI:1134540040
Name:ELITE ADULT DAY AND WELLNESS CENTER, INC
Entity type:Organization
Organization Name:ELITE ADULT DAY AND WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:UCHENIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-388-8141
Mailing Address - Street 1:209 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1801
Mailing Address - Country:US
Mailing Address - Phone:818-388-8141
Mailing Address - Fax:818-757-0903
Practice Address - Street 1:209 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1801
Practice Address - Country:US
Practice Address - Phone:818-388-8141
Practice Address - Fax:818-757-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care