| Elite Health | |
|
8707 Business Park Dr Shreveport LA 71105-5612 | |
| (318) 333-3105 | |
| (318) 888-0009 |
| Full Name | Elite Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8707 Business Park Dr, Shreveport, Louisiana |
| Authorized Official Name and Position | Suresh Sabbenahalli (PSYCHIATRIST) |
| Authorized Official Contact | 3183333105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Health 8707 Business Park Dr Shreveport LA 71105-5612 Ph: (318) 333-3105 | Elite Health 8707 Business Park Dr Shreveport LA 71105-5612 Ph: (318) 333-3105 |
| NPI Number | 1710755798 |
|---|---|
| Provider Enumeration Date | 12/19/2023 |
| Last Update Date | 05/23/2025 |
| Certification Date | 05/23/2025 |
| Medicare PECOS PAC ID | 7810337409 |
|---|---|
| Medicare Enrollment ID | O20240430001531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710755798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Suresh Sabbenahalli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528372505 PECOS PAC ID: 1759608581 Enrollment ID: I20150316001439 |
| Provider Name | Swathi Parvataneni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881079028 PECOS PAC ID: 8426354580 Enrollment ID: I20210609000733 |
| Provider Name | Roderickus K Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679965610 PECOS PAC ID: 4284009051 Enrollment ID: I20230408000015 |
| Provider Name | Jonathan Wayne Wiggins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861847675 PECOS PAC ID: 9436696200 Enrollment ID: I20240730002683 |
| Provider Name | Greta Anita Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215102462 PECOS PAC ID: 3072051838 Enrollment ID: I20240813000141 |
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