MEDICARE: TRUCARE ELEVATED WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1891428777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUCARE ELEVATED WELLNESS LLC

Provider Business Mailing Address
First Line	:	220 EAST AVE
Second Line	:
City	:	RIFLE
State	:	CO
Zip	:	81650-2332
Country	:	US
Telephone Number	:	970-625-5521
Fax Number	:	949-862-8886

Provider Business Practice Location Address
First Line	:	220 EAST AVE
Second Line	:
City	:	RIFLE
State	:	CO
Zip	:	81650-2332
Country	:	US
Telephone Number	:	970-625-5521
Fax Number	:	949-862-8886

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	COURTNEY A MORGAN
Credential	:
Telephone Number	:	970-625-5521

Provider Enumeration Date	:	07/07/2022
Last Update Date	:	06/28/2023

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