Provider Demographics
NPI:1770472961
Name:ELITE CARE ASSISTED LIVING FACILITY
Entity type:Organization
Organization Name:ELITE CARE ASSISTED LIVING FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANEIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-347-3171
Mailing Address - Street 1:6017 CHRISTINA DR E
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3420
Mailing Address - Country:US
Mailing Address - Phone:863-347-3171
Mailing Address - Fax:
Practice Address - Street 1:6017 CHRISTINA DR E
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3420
Practice Address - Country:US
Practice Address - Phone:863-347-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L & S ELITE GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility