Provider Demographics
NPI:1619852233
Name:ELITE HEALTH CARE AND WELLNESS COMMUNITY MENTAL CENTER LLC
Entity type:Organization
Organization Name:ELITE HEALTH CARE AND WELLNESS COMMUNITY MENTAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLORE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JESUCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-674-2881
Mailing Address - Street 1:345 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-2050
Mailing Address - Country:US
Mailing Address - Phone:954-304-9770
Mailing Address - Fax:954-304-9775
Practice Address - Street 1:345 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-2050
Practice Address - Country:US
Practice Address - Phone:954-304-9770
Practice Address - Fax:954-304-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)