Provider Demographics
NPI:1154917664
Name:ELITE CENTERS OF AMERICA, LLC
Entity type:Organization
Organization Name:ELITE CENTERS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-249-7470
Mailing Address - Street 1:2855 STAGE VILLAGE CV STE 7&8
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-4616
Mailing Address - Country:US
Mailing Address - Phone:901-249-7470
Mailing Address - Fax:
Practice Address - Street 1:2855 STAGE VILLAGE CV STE 7&8
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-4616
Practice Address - Country:US
Practice Address - Phone:901-249-7470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health