Healthcare Provider Details

I. General information

NPI: 1932049038
Provider Name (Legal Business Name): ELEVATE BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 DUCKWOOD DR
EAGAN MN
55122-1451
US

IV. Provider business mailing address

1440 DUCKWOOD DR
EAGAN MN
55122-1451
US

V. Phone/Fax

Practice location:
  • Phone: 612-386-7222
  • Fax:
Mailing address:
  • Phone: 612-386-7222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW ROMMEL
Title or Position: OWNER
Credential:
Phone: 612-386-7222