Provider Demographics
NPI:1225821614
Name:ELDERLY ELEGANCE
Entity type:Organization
Organization Name:ELDERLY ELEGANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:BHS
Authorized Official - Phone:270-331-1044
Mailing Address - Street 1:2319 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-3140
Mailing Address - Country:US
Mailing Address - Phone:270-331-1044
Mailing Address - Fax:
Practice Address - Street 1:2319 HARRISON ST
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-3140
Practice Address - Country:US
Practice Address - Phone:270-331-1044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health