Provider Demographics
NPI:1932730165
Name:ELITE HEALTHCARE GROUP. LLC,
Entity Type:Organization
Organization Name:ELITE HEALTHCARE GROUP. LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-869-2048
Mailing Address - Street 1:56 PERIMETER CTR E STE 150.00
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2296
Mailing Address - Country:US
Mailing Address - Phone:770-869-2018
Mailing Address - Fax:470-539-4999
Practice Address - Street 1:56 PERIMETER CTR E STE 150.00
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2296
Practice Address - Country:US
Practice Address - Phone:770-869-2018
Practice Address - Fax:470-539-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based