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General NPI Number Information
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NPI Number | 1578395877
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Entity Type | Organization
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Legal Business Name | FOUNDATION FOR ELEVATION LLC
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Dates
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Enumeration Date | 08/15/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 224 N MAIN ST STE 102
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City | HOPEWELL
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State | VA
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Zip | 23860-2700
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Country | US
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Telephone | 804-255-3157
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Fax |
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Provider Business Mailing Address
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Address Line | 11329 CEDAR RUN RD
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City | SOUTH PRINCE GEORGE
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State | VA
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Zip | 23805-4105
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Country | US
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Telephone | 804-255-3157
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS LASHAE D SYKES
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Credential |
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Telephone | 804-255-3157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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