Provider Demographics
NPI:1205067956
Name:ELITE CHOICE HOME CARE
Entity type:Organization
Organization Name:ELITE CHOICE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:MARIANNE
Authorized Official - Last Name:BASTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:619-316-3375
Mailing Address - Street 1:PO BOX 211663
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91921-1663
Mailing Address - Country:US
Mailing Address - Phone:619-316-3375
Mailing Address - Fax:619-934-8663
Practice Address - Street 1:2155 CORTE VIS
Practice Address - Street 2:114
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-4120
Practice Address - Country:US
Practice Address - Phone:619-316-3375
Practice Address - Fax:619-934-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health