Elite Life Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ELITE LIFE CARE LLC

Practice address

2112 William St
Cape Girardeau, MO 63703-5818

Phone

(573) 803-9320

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Nancy Heffner

Title

Sole Member

Phone

(573) 238-4597

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1225678485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARBLE HILL",
            "state": "MO",
            "postal_code": "637640188",
            "telephone_number": "573-561-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 WILLIAM ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035818",
            "telephone_number": "573-803-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE LIFE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "HEFFNER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "573-238-4597"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.