Provider Demographics
NPI:1457887390
Name:ELITE ALTERNATIVES, INC.
Entity Type:Organization
Organization Name:ELITE ALTERNATIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-852-2065
Mailing Address - Street 1:3330 PRIMARY ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-3243
Mailing Address - Country:US
Mailing Address - Phone:248-852-2065
Mailing Address - Fax:
Practice Address - Street 1:3330 PRIMARY ST
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-3243
Practice Address - Country:US
Practice Address - Phone:248-852-2065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS630012584253J00000X
MIAS630012646253J00000X
MIAS630274298253J00000X
MIAS630012747253J00000X
MIAS500268244253J00000X
MIAS500081671253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency