Organization
ELITE COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN APPENZELLER (C.O.O.)
(888) 558-1275
Entity
Organization
Contact information
Practice address
3651 E BASELINE RD, #E-222, GILBERT, AZ 85234-2689
(888) 558-1275
(480) 558-1276
Mailing address
3651 E. BASELINE RD., #E-222, GILBERT, AZ 85234
(888) 558-1275
(480) 558-1276
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
L-1449513-8
AZ
253Z00000X
In Home Supportive Care Agency
Primary
NV20121451557
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
385750
AHCCCS - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM CERTIFICATION
AZ
01
—
RFQVA DDD710000
AZ DEPT. OF ECONOMIC SECURITY CERTIFICATE FOR HOME AND COMMUNITY BASED SERVICES
AZ
Enumeration date
03/28/2013
Last updated
04/04/2013
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