Organization
ELITES CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AWONTI THIERRY ETOO NDJONGO (CHIEF EXECUTIVE OFFICER)
(240) 988-6871
Entity
Organization
Contact information
Practice address
6305 IVY LN STE 230, GREENBELT, MD 20770-6314
(240) 825-3153
(240) 825-3154
Mailing address
6305 IVY LN STE 230, GREENBELT, MD 20770-6314
(240) 825-3153
(240) 825-3154
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/15/2017
Last updated
08/19/2022
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