Provider Demographics
NPI:1336860071
Name:ELEVATE SWALLOWING AND VOICE SOLUTIONS LLC
Entity Type:Organization
Organization Name:ELEVATE SWALLOWING AND VOICE SOLUTIONS LLC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCARSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:LSP
Authorized Official - Phone:479-295-0316
Mailing Address - Street 1:10 BLIZZEN LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3236
Mailing Address - Country:US
Mailing Address - Phone:479-295-0316
Mailing Address - Fax:
Practice Address - Street 1:3901 PARKWAY CIR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6362
Practice Address - Country:US
Practice Address - Phone:479-295-0316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty