Provider Demographics
NPI:1205501988
Name:ELITE PERSONAL HOME CARE, LLC.
Entity type:Organization
Organization Name:ELITE PERSONAL HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-833-0020
Mailing Address - Street 1:301 MAIN ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136
Mailing Address - Country:US
Mailing Address - Phone:410-833-0020
Mailing Address - Fax:
Practice Address - Street 1:301 MAIN ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:410-833-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty