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General NPI Number Information
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NPI Number | 1336084649
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Entity Type | Organization
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Legal Business Name | ELEVATE WELLNESS AGENCY LLC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 707 HIGHWAY 33 S STE 9
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City | CLOQUET
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State | MN
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Zip | 55720-2665
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Country | US
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Telephone | 218-499-0834
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Fax | 218-878-5788
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Provider Business Mailing Address
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Address Line | 707 HIGHWAY 33 S STE 9
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City | CLOQUET
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State | MN
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Zip | 55720-2665
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Country | US
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Telephone | 218-499-0834
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Fax | 218-878-5788
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY K SKYBERG
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Credential |
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Telephone | 218-348-6978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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