Healthcare Provider Details

I. General information

NPI: 1205673399
Provider Name (Legal Business Name): ELEVATE MEDCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 S HWY A1A
MELBOURNE FL
32951-3908
US

IV. Provider business mailing address

7765 S HWY A1A
MELBOURNE BEACH FL
32951-3908
US

V. Phone/Fax

Practice location:
  • Phone: 937-622-1592
  • Fax:
Mailing address:
  • Phone: 937-478-3386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DANA LYNN MCDONOUGH
Title or Position: PRESIDENT
Credential:
Phone: 937-478-3386