ELITE CARE SERVICE INC (NPI# 1750716445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750716445 |
| Entity Type | Organization |
| Organization Name | ELITE CARE SERVICE INC |
| Practice Address |
111 Lamon St 103 Fayetteville NC 28301-4901 |
| Mailing Address |
Po Box 9525 Fayetteville NC 28311-9088 |
| Practice Telephone | 9104830324 |
| Practice Fax Number | 9104832246 |
| Mailing Telephone | 9104830324 |
| Mailing Fax Number | 9104832246 |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |
| Authorized Official Name | MR. BARSHEEM CHAPMAN (CEO) |
| Authorized Official Telephone | 9104830324 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7806072 | 05 |
| Street Address |
111 LAMON ST 103 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28301-4901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321592 | Doris Ann Moore-russell | Social Worker | 111 Lamon St, Suite 212, Fayetteville, NC 28301-4957 | 2005-10-27 |
| 1912457060 | William Willis | Counselor | 111 Lamon St, Suite 103, Fayetteville, NC 28301-4901 | 2016-10-12 |
| 1548710023 | Elite Care | Case Management | 111 Lamon St, Fayetteville, NC 28301 | 2016-10-10 |
| 1003223066 | Chapmans Management Company | Psychiatric Residential Treatment Facility | 111 Lamon St, Fayetteville, NC 28301-4901 | 2014-07-22 |
| 1932534625 | Elite Care Service Inc. | Counselor | 111 Lamon St, 103, Fayetteville, NC 28301-4901 | 2013-09-12 |
| 1841625530 | Elite Care Service Inc. | Psychologist | 111 Lamon St, 103, Fayetteville, NC 28301-4901 | 2013-09-12 |
| 1508290420 | Elite Adolescent Care, Inc. | Counselor | 111 Lamon St, 103, Fayetteville, NC 28301-4901 | 2013-08-27 |
| 1073853313 | Drako Munn | Technician | 111 Lamon St, Suite 101, Fayetteville, NC 28301-4901 | 2013-02-24 |
| 1497041032 | J J Compassionate Home Care | Preferred Provider Organization | 111 Lamon St, Suite 207, Fayetteville, NC 28301-4901 | 2011-06-22 |
| 1265728869 | Central Carolina Home Healthcare | Home Health | 111 Lamon St, Suite 119, Fayetteville, NC 28301-4901 | 2011-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
| 1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
| 1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
| 1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
| 1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
| 1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
| 1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
| 1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
| 1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
| 1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
| Find all providers in zip 28301 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548793441 | Stonebridge Family Counseling | Community Based Residential Treatment Facility, Mental Illness | 209 Edison St E, Fayetteville, TN 37334-3007 | 2017-04-06 |
| 1366846404 | The Loving Home,inc. #6 | Community Based Residential Treatment Facility, Mental Illness | 1903 Bridger St, Fayetteville, NC 28301-3913 | 2014-10-17 |
| 1063814127 | Joyoflivingprogramsforyouthandfamiliesnetwork | Community Based Residential Treatment Facility, Mental Illness | 170 Hilo Rd, 1803 Hwy 92 N, Fayetteville, GA 30215-2402 | 2014-09-20 |
| 1770924482 | Pelham Supportive Services | Community Based Residential Treatment Facility, Mental Illness | 5740 Longview Dr, Fayetteville, NC 28306-8567 | 2013-07-10 |
| 1003167586 | Upward Process Inc. | Community Based Residential Treatment Facility, Mental Illness | 568 Alleghany Rd, Fayetteville, NC 28304 | 2012-09-25 |
| 1629369012 | New Horizons Group Home | Community Based Residential Treatment Facility, Mental Illness | 3117 Dyke St, Fayetteville, NC 28306-2808 | 2011-04-20 |
| 1053626135 | Pelham Supportive Services | Community Based Residential Treatment Facility, Mental Illness | 2226 Memory St, Fayetteville, NC 28304-5827 | 2010-08-12 |
| 1295960326 | Precious Haven Inc. | Community Based Residential Treatment Facility, Mental Illness | 7762 Hazelwood Ave, Fayetteville, NC 28314-6246 | 2009-05-19 |
| 1710122114 | Melrose Center | Community Based Residential Treatment Facility, Mental Illness | 421 Maiden Ln Ste 207, Fayetteville, NC 28301-5055 | 2008-12-14 |
| 1710144738 | Pelham Supportive Services | Community Based Residential Treatment Facility, Mental Illness | 4906 Redwood Dr, Fayetteville, NC 28304-4213 | 2008-05-19 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28301 |
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| 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.