Organization
ELITE PERSONAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY L WILLIAMS (PRESIDENT)
(941) 740-1460
Entity
Organization
Contact information
Practice address
18020 OHARA DR, PORT CHARLOTTE, FL 33948-9568
(941) 740-1460
(941) 627-3402
Mailing address
PO BOX 380923, MURDOCK, FL 33938-0923
(940) 740-1460
(941) 627-3402
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690968096
—
FL
05
—
690968098
—
FL
Enumeration date
12/15/2010
Last updated
12/15/2010
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