Healthcare Provider Details

I. General information

NPI: 1558134965
Provider Name (Legal Business Name): ELEVA RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN PABLO # 70
BAYAMON PR
00961-7041
US

IV. Provider business mailing address

PO BOX 3968
GUAYNABO PR
00970-3968
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-1000
  • Fax: 787-653-3535
Mailing address:
  • Phone: 787-720-1000
  • Fax: 787-653-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MILTON L. CRUZ
Title or Position: CEO
Credential:
Phone: 787-706-5255