ELITE 360 HEALTH AND WELLNESS


Address: 1409 S Lamar, Ste. 245, Dallas, TX 75215-6818
Phone: 2145878655

ELITE 360 HEALTH AND WELLNESS (NPI# 1376016410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376016410
Entity Type Organization
Organization Name ELITE 360 HEALTH AND WELLNESS
Practice Address 1409 S Lamar
Ste. 245
Dallas
TX 75215-6818
Practice Telephone 2145878655
Practice Fax Number 2142429696
Mailing Telephone 2145878655
Mailing Fax Number 2142429696
Enumeration Date 2019-01-10
Last Update Date 2019-01-10
Authorized Official Name DANIELL NICOLE LUCAS (OWNER)
Authorized Official Telephone 2145878655
Authorized Official Credential MT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0401X Clinic/Center
Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Ambulatory Health Care Facilities

Office Location

Street Address 1409 S LAMAR
STE. 245
City DALLAS
State TX
Zip Code 75215-6818

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Taxonomy Information

Taxonomy Code 261QR0401X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Taxonomy Definition

Definition to come...

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Competitor

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City DALLAS
Zip Code 75215

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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