Provider Demographics
NPI:1740539865
Name:ELITE THERAPY STAFFING
Entity type:Organization
Organization Name:ELITE THERAPY STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:704-796-3797
Mailing Address - Street 1:301 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-2648
Mailing Address - Country:US
Mailing Address - Phone:704-796-3797
Mailing Address - Fax:
Practice Address - Street 1:301 E 16TH ST
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-2648
Practice Address - Country:US
Practice Address - Phone:704-796-3797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7908224Z00000X
NC10090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty