Healthcare Provider Details

I. General information

NPI: 1467314302
Provider Name (Legal Business Name): ELEVATED LIVING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 W COLLEGE ST
MARSHALL MO
65340-2909
US

IV. Provider business mailing address

617 W COLLEGE ST
MARSHALL MO
65340-2909
US

V. Phone/Fax

Practice location:
  • Phone: 660-202-2129
  • Fax: 660-202-2129
Mailing address:
  • Phone: 660-202-2129
  • Fax: 660-202-2129

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: DASHAWNA LYNNELLE BROWN
Title or Position: OWNER/OPERATOR
Credential:
Phone: 660-202-2129