Provider Demographics
NPI:1114430782
Name:ELEVATE PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:ELEVATE PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:914-245-0298
Mailing Address - Street 1:334 UNDERHILL AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4543
Mailing Address - Country:US
Mailing Address - Phone:914-245-0298
Mailing Address - Fax:914-245-5367
Practice Address - Street 1:19 OLD KINGS HWY S STE 120
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4532
Practice Address - Country:US
Practice Address - Phone:203-621-0050
Practice Address - Fax:914-245-5367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEVATE HOLDING COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-06
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty