Healthcare Provider Details

I. General information

NPI: 1902741150
Provider Name (Legal Business Name): ELEVATING GENERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W 5TH AVE
GASTONIA NC
28052-3910
US

IV. Provider business mailing address

7842 MERIDALE FOREST DR
CHARLOTTE NC
28269-3467
US

V. Phone/Fax

Practice location:
  • Phone: 732-874-1188
  • Fax:
Mailing address:
  • Phone: 732-874-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANEIDRA LEMONS
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 732-874-1188