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General NPI Number Information
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NPI Number | 1043158553
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Entity Type | Organization
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Legal Business Name | ELEVATE SENIOR HEALTHCARE, LLC
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 19263 HAT RANCH DR
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City | BELLE FOURCHE
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State | SD
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Zip | 57717-6026
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Country | US
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Telephone | 605-940-5414
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Fax |
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Provider Business Mailing Address
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Address Line | 19263 HAT RANCH DR
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City | BELLE FOURCHE
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State | SD
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Zip | 57717-6026
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELSEY NYLANDER
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Credential | DO
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Telephone | 605-940-5414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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