Provider Demographics
NPI:1942805056
Name:ELEVATE HOSPICE, LLC
Entity Type:Organization
Organization Name:ELEVATE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-850-4089
Mailing Address - Street 1:88 E 100 S
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-3006
Mailing Address - Country:US
Mailing Address - Phone:435-637-1250
Mailing Address - Fax:435-637-1251
Practice Address - Street 1:88 E 100 S
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-3006
Practice Address - Country:US
Practice Address - Phone:435-637-1250
Practice Address - Fax:435-637-1251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based