Healthcare Provider Details

I. General information

NPI: 1841102043
Provider Name (Legal Business Name): ELEVATED LIVING SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4461 ELDONE RD
BALTIMORE MD
21229-4513
US

IV. Provider business mailing address

4461 ELDONE RD
BALTIMORE MD
21229-4513
US

V. Phone/Fax

Practice location:
  • Phone: 227-268-2231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KIEARA BRAXTON
Title or Position: CEO
Credential:
Phone: 227-268-2231