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General NPI Number Information
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NPI Number | 1932089273
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Entity Type | Organization
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Legal Business Name | ELEVATE MENTAL HEALTH SERVICES INC
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 3702 S MURLO AVE
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City | MERIDIAN
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State | ID
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Zip | 83642-4873
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Country | US
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Telephone | 208-605-9860
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 S MURLO AVE
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City | MERIDIAN
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State | ID
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Zip | 83642-4873
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Country | US
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Telephone | 208-605-9860
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Fax |
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Authorized Official
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Title or Position | SHAREHOLDER
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Name | PARFAIT DIABATE ABAYISENGA
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Credential |
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Telephone | 208-605-9860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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