Organization
ELITE PRO HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE BLACKWELL JR. (CEO/OCCUPATIONAL THERAPIST)
(216) 789-0509
Entity
Organization
Contact information
Practice address
3406 SAVILLE LN, BOWIE, MD 20721-4035
(216) 789-0509
Mailing address
9606 WESTERDALE DR, UPPER MARLBORO, MD 20774-2461
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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