Organization
ELITE GROUP SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY SOUTHERLAND JD (CEO)
(910) 565-2857
Entity
Organization
Contact information
Practice address
1188 FAYETTEVILLE RD, RAEFORD, NC 28376-2536
(910) 565-2787
Mailing address
PO BOX 417, RAEFORD, NC 28376-0417
(910) 978-9118
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/01/2014
Last updated
04/15/2024
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