Healthcare Provider Details

I. General information

NPI: 1790602050
Provider Name (Legal Business Name): ELEVATE INDEPENDENT LIVING SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5024 FONTANA CT
DENVER CO
80239-4277
US

IV. Provider business mailing address

5024 FONTANA CT
DENVER CO
80239-4277
US

V. Phone/Fax

Practice location:
  • Phone: 720-338-9961
  • Fax:
Mailing address:
  • Phone: 720-338-9961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MARICRUZ DE LA ROSA
Title or Position: OWNER
Credential:
Phone: 720-338-9961