Organization
THE ELITIST GROUP
Active
Organization
THE ELITIST GROUP
Active
Parent organization
THE ELITIST GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE ELITIST GROUP
Authorized official
MR. LARRY GULLEY JR. (OWNER)
(815) 847-0647
Entity
Organization
Contact information
Practice address
2929 N MAIN STREET, ROCKFORD, IL 61103
(815) 847-0647
Mailing address
7359 SHILLLINGTON DRIVE, ROCKFORD, IL 61107
(815) 847-0647
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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