Provider Demographics
NPI:1043050875
Name:CROWNED ELITE SERVICES L.L.C.
Entity type:Organization
Organization Name:CROWNED ELITE SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-276-5401
Mailing Address - Street 1:26140 CROCKER BLVD
Mailing Address - Street 2:
Mailing Address - City:HARRISON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-2454
Mailing Address - Country:US
Mailing Address - Phone:586-276-5401
Mailing Address - Fax:586-846-2878
Practice Address - Street 1:26140 CROCKER BLVD
Practice Address - Street 2:
Practice Address - City:HARRISON TWP
Practice Address - State:MI
Practice Address - Zip Code:48045-2454
Practice Address - Country:US
Practice Address - Phone:586-276-5401
Practice Address - Fax:586-846-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health