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General NPI Number Information
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NPI Number | 1215754643
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Entity Type | Organization
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Legal Business Name | ELEVATE HEALTH LLC
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 176 THOMAS JOHNSON DR STE 203
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City | FREDERICK
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State | MD
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Zip | 21702-4535
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Country | US
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Telephone | 240-831-1921
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Fax |
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Provider Business Mailing Address
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Address Line | 10923 LOUIS DETRICK LN
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City | MONROVIA
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State | MD
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Zip | 21770-6024
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Country | US
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Telephone | 707-637-6859
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA OGBODO
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Credential |
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Telephone | 707-637-6859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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