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General NPI Number Information
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NPI Number | 1417838954
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Entity Type | Organization
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Legal Business Name | ELEVATE HEALTHCARE NOCO LLC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 950 37TH AVENUE CT
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City | GREELEY
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State | CO
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Zip | 80634-1802
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Country | US
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Telephone | 719-696-9027
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 291
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City | WINDSOR
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State | CO
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Zip | 80550-0291
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Country | US
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Telephone | 719-696-9027
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PERLA RAMIREZ-GROOTHUIS
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Credential |
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Telephone | 719-696-9027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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