Provider Demographics
NPI:1083495311
Name:ELEMENTS OF LIFE
Entity Type:Organization
Organization Name:ELEMENTS OF LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-606-4811
Mailing Address - Street 1:3143 BELLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2620
Mailing Address - Country:US
Mailing Address - Phone:190-160-6481
Mailing Address - Fax:
Practice Address - Street 1:3143 BELLE GROVE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2620
Practice Address - Country:US
Practice Address - Phone:901-606-4811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker