ELITE COMMUNITY HEALTH, LLC

Provider Demographics

• NPI: 1396051884
• Name: ELITE COMMUNITY HEALTH, LLC
• Entity type: Organization
• Organization Name: ELITE COMMUNITY HEALTH, LLC
• Authorized Official - Title/Position: OWNER
• Authorized Official - First Name: JOSHUA
• Authorized Official - Last Name: STEELE
• Authorized Official - Phone: 704-674-4129
• Mailing Address - Street 1: 2212 UNION RD
• Mailing Address - Street 2: SUITE 700, PMB 507
• Mailing Address - City: GASTONIA
• Mailing Address - State: NC
• Mailing Address - Zip Code: 28054-3700
• Mailing Address - Country: US
• Practice Address - Street 1: 2721 X RAY DR
• Practice Address - City: GASTONIA
• Practice Address - State: NC
• Practice Address - Zip Code: 28054-7491
• Practice Address - Country: US
• Practice Address - Phone: 704-864-9668
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2010-08-23
• Last Update Date: 2013-04-10

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	251S00000X	Agencies	Community/Behavioral Health
No	251B00000X	Agencies	Case Management		Group - Single Specialty
No	101YA0400X	Behavioral Health & Social Service Providers	Counselor	Addiction (Substance Use Disorder)	Group - Single Specialty
No	101YM0800X	Behavioral Health & Social Service Providers	Counselor	Mental Health	Group - Single Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Single Specialty
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NC	6112206	Medicaid
NC	8300629Q	Medicaid
NC	6007585	Medicaid
NC	8300629P	Medicaid
NC	891312F	Medicaid
NC	6104657	Medicaid
NC	6106831	Medicaid
NC	8300629G	Medicaid
NC	8300629V	Medicaid
NC	8300629	Medicaid
NC	8300629H	Medicaid
NC	8703106	Medicaid
NC	6104752	Medicaid
NC	6002794	Medicaid
NC	6002796	Medicaid
NC	6112011	Medicaid
NC	6112183	Medicaid
NC	6112183	Medicaid