Healthcare Provider Details

I. General information

NPI: 1720939564
Provider Name (Legal Business Name): ELEVATE RECUPERATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6931 TOPANGA CANYON BLVD STE 1
CANOGA PARK CA
91303-2360
US

IV. Provider business mailing address

6931 TOPANGA CANYON BLVD STE 1
CANOGA PARK CA
91303-2360
US

V. Phone/Fax

Practice location:
  • Phone: 213-394-0248
  • Fax:
Mailing address:
  • Phone: 213-394-0248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ALBERT ELOMINA
Title or Position: CEO
Credential:
Phone: 213-394-0248