Provider Demographics
NPI:1932563657
Name:ELITE CARE SERVICES, INC
Entity Type:Organization
Organization Name:ELITE CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DIA'SHEEMA
Authorized Official - Middle Name:KEYONNA
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:BS HUMANITIES
Authorized Official - Phone:352-348-3989
Mailing Address - Street 1:707 S LONE OAK DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6215
Mailing Address - Country:US
Mailing Address - Phone:352-348-3989
Mailing Address - Fax:352-787-0997
Practice Address - Street 1:707 S LONE OAK DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6215
Practice Address - Country:US
Practice Address - Phone:352-348-3989
Practice Address - Fax:352-787-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities