Elite Choice Companion Care Services LLC

Primary specialty

Adult CompanionTaxonomy code 372600000X

License

235037 Issued in FL

Legal business name

ELITE CHOICE COMPANION CARE SERVICES LLC

Practice address

173 San Juan Cir
Melbourne, FL 32935-5453

Phone

(321) 216-5562

NPI assigned

Oct 22, 2017

Last updated

Oct 22, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela Shackelford

Title

Administrator

Phone

(321) 216-5562

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508630400000",
    "number": "1164933727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 SAN JUAN CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355453",
            "telephone_number": "321-216-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 SAN JUAN CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355453",
            "telephone_number": "321-216-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CHOICE COMPANION CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-22",
        "last_updated": "2017-10-22",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-216-5562"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": "FL",
            "license": "235037",
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "FL",
            "license": "235037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Companion in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Adult Companion in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.