Healthcare Provider Details

I. General information

NPI: 1902724941
Provider Name (Legal Business Name): ELEVATE COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3776 N MAPLE GROVE CT
BOISE ID
83704-4224
US

IV. Provider business mailing address

3776 N MAPLE GROVE CT
BOISE ID
83704-4224
US

V. Phone/Fax

Practice location:
  • Phone: 208-801-1999
  • Fax:
Mailing address:
  • Phone: 208-801-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SHALOM SAFARI
Title or Position: OWNER
Credential: RN
Phone: 208-801-1999