Provider Demographics
NPI:1649700261
Name:ELITES CARE LLC
Entity type:Organization
Organization Name:ELITES CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AWONTI
Authorized Official - Middle Name:THIERRY
Authorized Official - Last Name:ETOO NDJONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-988-6871
Mailing Address - Street 1:6305 IVY LN STE 230
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-6314
Mailing Address - Country:US
Mailing Address - Phone:240-825-3153
Mailing Address - Fax:240-825-3154
Practice Address - Street 1:6305 IVY LN STE 230
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6314
Practice Address - Country:US
Practice Address - Phone:240-825-3153
Practice Address - Fax:240-825-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty