Provider Demographics
NPI:1922428739
Name:ELEVATE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:ELEVATE HOME HEALTH, LLC
Other - Org Name:OASIS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-349-1200
Mailing Address - Street 1:27071 ALISO CREEK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5327
Mailing Address - Country:US
Mailing Address - Phone:949-349-1200
Mailing Address - Fax:949-349-1122
Practice Address - Street 1:720 E CHARLESTON BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1545
Practice Address - Country:US
Practice Address - Phone:702-382-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6271HHA-3251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV297106Medicare Oscar/Certification