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NPI Code Detail

MEDICARE: ELEVATE HEALTHCARE SERVICES, LLC

MEDICARE: ELEVATE HEALTHCARE SERVICES, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1497292197
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELEVATE HEALTHCARE SERVICES, LLC
Provider Business Mailing Address
First Line : 3053 W CRAIG RD STE E
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-5128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5239 ENGLISH ASTER CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-4004
Country : US
Telephone Number : 702-763-7365
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER/MEMBER
Name : TONEY JEVON BANKS
Credential :
Telephone Number : 702-845-1862
Provider Enumeration Date : 01/20/2017
Last Update Date : 01/20/2017

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Directions to “ELEVATE HEALTHCARE SERVICES, LLC ” Practice Location

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