Provider Demographics
NPI:1588008759
Name:ELEVATE HEALTH AZ, PLLC
Entity Type:Organization
Organization Name:ELEVATE HEALTH AZ, PLLC
Other - Org Name:N1 HEALTH DR. MCHENRY, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-391-5004
Mailing Address - Street 1:9821 N 95TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4589
Mailing Address - Country:US
Mailing Address - Phone:480-525-5775
Mailing Address - Fax:480-525-5776
Practice Address - Street 1:9821 N 95TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4589
Practice Address - Country:US
Practice Address - Phone:480-525-5775
Practice Address - Fax:480-525-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty