Provider Demographics
NPI:1215111588
Name:ELEGANCE HEALTHCARE INC
Entity type:Organization
Organization Name:ELEGANCE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-761-7786
Mailing Address - Street 1:11026 VICTORY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3720
Mailing Address - Country:US
Mailing Address - Phone:818-761-7786
Mailing Address - Fax:818-761-7789
Practice Address - Street 1:11026 VICTORY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3720
Practice Address - Country:US
Practice Address - Phone:818-761-7786
Practice Address - Fax:818-761-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CA50001220251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health