Provider Demographics
NPI:1710755798
Name:ELITE HEALTH
Entity type:Organization
Organization Name:ELITE HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SABBENAHALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-333-3105
Mailing Address - Street 1:8707 BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5612
Mailing Address - Country:US
Mailing Address - Phone:318-333-3105
Mailing Address - Fax:318-888-0009
Practice Address - Street 1:8707 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5612
Practice Address - Country:US
Practice Address - Phone:318-333-3105
Practice Address - Fax:318-888-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty