Provider Demographics
NPI:1891428777
Name:TRUCARE ELEVATED WELLNESS LLC
Entity Type:Organization
Organization Name:TRUCARE ELEVATED WELLNESS LLC
Other - Org Name:TRUCARE ELEVATED WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-625-5521
Mailing Address - Street 1:220 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-2332
Mailing Address - Country:US
Mailing Address - Phone:970-625-5521
Mailing Address - Fax:949-862-8886
Practice Address - Street 1:220 EAST AVE
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-2332
Practice Address - Country:US
Practice Address - Phone:970-625-5521
Practice Address - Fax:949-862-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center