Healthcare Provider Details

I. General information

NPI: 1871163824
Provider Name (Legal Business Name): ELEVATION SPEECH-LANGUAGE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6155 ESTES ST
ARVADA CO
80004-5445
US

IV. Provider business mailing address

6155 ESTES ST
ARVADA CO
80004-5445
US

V. Phone/Fax

Practice location:
  • Phone: 913-530-5355
  • Fax:
Mailing address:
  • Phone: 913-530-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA3000X
TaxonomyAugmentative Communication Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNE ELIZABETH O'MARA
Title or Position: OWNER
Credential:
Phone: 913-530-5355