# ELITE PRO HOME HEALTH

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

## Provider details

- **NPI number:** 1770274383
- **Authorized official:** MR. LAVELLE BLACKWELL JR. (CEO/OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (216) 789-0509

## Contact information

- **Practice address:** 3406 SAVILLE LN, BOWIE, MD 20721-4035
- **Practice address phone:** (216) 789-0509
- **Mailing address:** 9606 WESTERDALE DR, UPPER MARLBORO, MD 20774-2461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/16/2023
- **Last updated:** 05/16/2023