Provider Demographics
NPI:1912524356
Name:ELITE HOSPICE AND PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:ELITE HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIRBOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-217-2034
Mailing Address - Street 1:106 S GRAPE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4407
Mailing Address - Country:US
Mailing Address - Phone:602-790-3300
Mailing Address - Fax:858-726-8977
Practice Address - Street 1:106 S GRAPE ST STE 2
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4407
Practice Address - Country:US
Practice Address - Phone:480-217-2034
Practice Address - Fax:858-726-8977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based