Provider Demographics
NPI:1871373647
Name:ELITE EXCELLENCE LLC
Entity type:Organization
Organization Name:ELITE EXCELLENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TRENT
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-837-7084
Mailing Address - Street 1:1783 FOREST DR STE 325
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4229
Mailing Address - Country:US
Mailing Address - Phone:443-758-4494
Mailing Address - Fax:
Practice Address - Street 1:2086 GENERALS HWY STE 304
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-6759
Practice Address - Country:US
Practice Address - Phone:443-837-7084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)