Provider Demographics
NPI:1114633120
Name:ELEVATED CARE SERVICE
Entity Type:Organization
Organization Name:ELEVATED CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:952-457-3208
Mailing Address - Street 1:7900 INTERNATIONAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2562
Mailing Address - Country:US
Mailing Address - Phone:952-457-3208
Mailing Address - Fax:612-460-6509
Practice Address - Street 1:7900 INTERNATIONAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2562
Practice Address - Country:US
Practice Address - Phone:952-457-3208
Practice Address - Fax:612-460-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health