Provider Demographics
NPI:1205494341
Name:ELEVATED OUTCOMES, INC
Entity type:Organization
Organization Name:ELEVATED OUTCOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-873-0599
Mailing Address - Street 1:3000 S RANDOLPH ST APT 308
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2252
Mailing Address - Country:US
Mailing Address - Phone:301-873-0599
Mailing Address - Fax:
Practice Address - Street 1:3000 S RANDOLPH ST APT 308
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2252
Practice Address - Country:US
Practice Address - Phone:301-873-0599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty