MEDICARE: ELEVATED LIFESTYLE SOLUTIONS

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1922849652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATED LIFESTYLE SOLUTIONS

Provider Business Mailing Address
First Line	:	3220 KIRBY DR STE 140
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5549
Country	:	US
Telephone Number	:	832-472-0065
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 KIRBY DR STE 140
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5549
Country	:	US
Telephone Number	:	832-472-0065
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TEIRA BROWN
Credential	:
Telephone Number	:	832-472-0065

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	06/05/2024

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Directions to “ELEVATED LIFESTYLE SOLUTIONS ” Practice Location

Language	Start Address	Practice Location

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