# ELITE THERAPY AND WELLNESS CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508229782
- **Authorized official:** TAMMY ANN WELDON RN (OWNER)
- **Authorized official phone:** (719) 543-2700

## Contact information

- **Practice address:** 3715 THATCHER AVE, PUEBLO, CO 81005-1255
- **Practice address phone:** (719) 470-2281
- **Practice address fax:** (719) 301-7218
- **Mailing address:** 3715 THATCHER AVE, PUEBLO, CO 81005-1255
- **Mailing address phone:** (719) 470-2281
- **Mailing address fax:** (719) 301-7218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/04/2016
- **Last updated:** 03/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9000197949 | — | CO |