Provider Demographics
NPI:1891538781
Name:ELITE PERSONAL CARE GROUP, INC.
Entity type:Organization
Organization Name:ELITE PERSONAL CARE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:LUCKY
Authorized Official - Suffix:II
Authorized Official - Credentials:PHDCCMHT
Authorized Official - Phone:912-744-9276
Mailing Address - Street 1:216 LAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-1231
Mailing Address - Country:US
Mailing Address - Phone:912-744-9276
Mailing Address - Fax:
Practice Address - Street 1:216 LAWTON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-1231
Practice Address - Country:US
Practice Address - Phone:912-658-9125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2025-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty