Provider Demographics
NPI:1447315221
Name:ELITE HOME CARE SERVICES, INC.
Entity type:Organization
Organization Name:ELITE HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-647-9869
Mailing Address - Street 1:PO BOX 1943
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28145-1943
Mailing Address - Country:US
Mailing Address - Phone:704-279-0738
Mailing Address - Fax:704-279-0758
Practice Address - Street 1:812 W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4152
Practice Address - Country:US
Practice Address - Phone:704-647-9869
Practice Address - Fax:704-647-9679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3556251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601588Medicaid
NC3418245Medicaid