Provider Demographics
NPI:1508338690
Name:ELEVATE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ELEVATE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:CANARIOS
Authorized Official - Last Name:BARILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-271-9962
Mailing Address - Street 1:5160 VILLAGE CREEK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4423
Mailing Address - Country:US
Mailing Address - Phone:214-271-9962
Mailing Address - Fax:214-964-0817
Practice Address - Street 1:5160 VILLAGE CREEK DR STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4423
Practice Address - Country:US
Practice Address - Phone:214-271-9962
Practice Address - Fax:214-964-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-29
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4012718Medicaid
TX3663353Medicaid