Healthcare Provider Details

I. General information

NPI: 1336065952
Provider Name (Legal Business Name): ELEVATE RESIDENTIAL LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5206 BELLEVILLE AVE
BALTIMORE MD
21207-7043
US

IV. Provider business mailing address

5206 BELLEVILLE AVE
BALTIMORE MD
21207-7043
US

V. Phone/Fax

Practice location:
  • Phone: 443-955-1081
  • Fax:
Mailing address:
  • Phone: 443-955-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: NATASHA JACOBS
Title or Position: OWNER
Credential: RN
Phone: 443-955-1081