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General NPI Number Information
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NPI Number | 1053034199
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Entity Type | Organization
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Legal Business Name | COMMUNITY ELEVATION LLC
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3657 BURNHAM RD
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City | ANN ARBOR
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State | MI
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Zip | 48108-9662
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Country | US
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Telephone | 734-263-9100
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Fax | 734-369-8544
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Provider Business Mailing Address
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Address Line | 3657 BURNHAM RD
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City | ANN ARBOR
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State | MI
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Zip | 48108-9662
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Country | US
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Telephone | 734-263-9100
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Fax | 734-369-8544
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Authorized Official
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Title or Position | CLINICAL SOCIAL WOKER
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Name | MR. DELLKAWAA PAUL JACOBS
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Credential | LMSW
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Telephone | 734-263-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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