Healthcare Provider Details

I. General information

NPI: 1053913590
Provider Name (Legal Business Name): LIFE ELEVATIONS CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 S CLEVELAND MASSILLON RD STE A109
COPLEY OH
44321-1683
US

IV. Provider business mailing address

1270 S CLEVELAND MASSILLON RD STE A109
COPLEY OH
44321-1683
US

V. Phone/Fax

Practice location:
  • Phone: 330-957-9226
  • Fax:
Mailing address:
  • Phone: 330-957-9226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DENAY ANDERSON
Title or Position: OWNER
Credential:
Phone: 234-230-4547