MEDICARE: GREATER ELEVATIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251F00000X	Home Infusion Agency
2	251G00000X	Community Based Hospice Care Agency
3	251J00000X	Nursing Care Agency
4	251E00000X	Home Health Agency
5	253Z00000X	In Home Supportive Care Agency
6	291U00000X	Clinical Medical Laboratory
7	163WA2000X	Administrator Registered Nurse

General Provider Information

NPI Number	:	1063043636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER ELEVATIONS LLC

Provider Business Mailing Address
First Line	:	PO BOX 1581
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77383-1581
Country	:	US
Telephone Number	:	832-661-8344
Fax Number	:

Provider Business Practice Location Address
First Line	:	19403 SANCTUARY PINE CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-2628
Country	:	US
Telephone Number	:	832-661-8344
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JACQUELYN LETORY BHONES
Credential	:	BSN, RN
Telephone Number	:	832-296-7709

Provider Enumeration Date	:	01/31/2020
Last Update Date	:	02/22/2021

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Directions to “GREATER ELEVATIONS LLC ” Practice Location

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