Healthcare Provider Details

I. General information

NPI: 1508703273
Provider Name (Legal Business Name): ELEVATE HUMAN SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 CORRIHER SPRINGS RD
CHINA GROVE NC
28023-8772
US

IV. Provider business mailing address

242 OAK AVE
KANNAPOLIS NC
28081-4329
US

V. Phone/Fax

Practice location:
  • Phone: 586-854-9097
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMES STATEN
Title or Position: OWNER
Credential:
Phone: 586-854-9097