Provider Demographics
NPI:1083455034
Name:REIDS ELITE KARE LLC
Entity type:Organization
Organization Name:REIDS ELITE KARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA/HHA
Authorized Official - Prefix:
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:N
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-548-0602
Mailing Address - Street 1:11582 SW VILLAGE PKWY UNIT 146
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2392
Mailing Address - Country:US
Mailing Address - Phone:772-271-0475
Mailing Address - Fax:
Practice Address - Street 1:2185 ROBERT J CONLAN BLVD NE APT 101
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2765
Practice Address - Country:US
Practice Address - Phone:772-271-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services