Healthcare Provider Details

I. General information

NPI: 1962214692
Provider Name (Legal Business Name): ELEVATE MEMPHIS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5144 COUNTRY VIEW LN
MEMPHIS TN
38134-5210
US

IV. Provider business mailing address

501 UNION ST STE 545
NASHVILLE TN
37219-1876
US

V. Phone/Fax

Practice location:
  • Phone: 901-849-0018
  • Fax:
Mailing address:
  • Phone: 901-849-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: TAMIKA Y WILLIAMS
Title or Position: OWNER/FOUNDER/CAO
Credential:
Phone: 901-849-0018