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General NPI Number Information
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NPI Number | 1821819285
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Entity Type | Organization
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Legal Business Name | ELEVATED HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 310 MID CONTINENT PLZ STE 604A
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1763
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Country | US
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Telephone | 870-394-9711
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 63
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City | WEST MEMPHIS
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State | AR
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Zip | 72303-0063
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Country | US
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Telephone | 870-514-7919
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHEILA L MILLER
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Credential |
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Telephone | 870-514-7919
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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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