Provider Demographics
NPI:1184332892
Name:ELITE HOME CARE GROUP
Entity type:Organization
Organization Name:ELITE HOME CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FAYSAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-254-6117
Mailing Address - Street 1:9655 GRANITE RIDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2676
Mailing Address - Country:US
Mailing Address - Phone:855-513-3444
Mailing Address - Fax:
Practice Address - Street 1:9655 GRANITE RIDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2676
Practice Address - Country:US
Practice Address - Phone:855-513-3444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care