New Elite Group Home

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

NEW ELITE GROUP HOME

Practice address

1241 SE Navajo LN
Port St Lucie, FL 34983-3100

Phone

(772) 240-8307

Fax

(772) 905-8711

NPI assigned

Mar 7, 2022

Organization subpart

No

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

Authorized official

Name

Anide Etienne

Title

Owner

Phone

(772) 240-8307

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1699422949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 SE NAVAJO LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833100",
            "telephone_number": "772-240-8307",
            "fax_number": "772-905-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 SE NAVAJO LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833100",
            "telephone_number": "772-240-8307",
            "fax_number": "772-905-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ELITE GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "ANIDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-240-8307"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.