Provider Demographics
NPI:1114733664
Name:ELITE HEALTH GROUP INC
Entity type:Organization
Organization Name:ELITE HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL JOSEPH
Authorized Official - Middle Name:MAPOY
Authorized Official - Last Name:ISADA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:917-815-0403
Mailing Address - Street 1:6117 PERCUSSION CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6886
Mailing Address - Country:US
Mailing Address - Phone:917-815-0403
Mailing Address - Fax:702-745-1961
Practice Address - Street 1:6117 PERCUSSION CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-6886
Practice Address - Country:US
Practice Address - Phone:917-815-0403
Practice Address - Fax:702-745-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty