Provider Demographics
NPI:1205581477
Name:ELEVATE MENTAL HEALTH LLC
Entity type:Organization
Organization Name:ELEVATE MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CANER
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-859-3851
Mailing Address - Street 1:218 HEARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-7995
Mailing Address - Country:US
Mailing Address - Phone:910-859-3851
Mailing Address - Fax:
Practice Address - Street 1:8400 NORMANDALE LAKE BLVD STE 964
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-1085
Practice Address - Country:US
Practice Address - Phone:910-859-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health