Provider Demographics
NPI:1750112108
Name:ELEVATE THERAPY SERVICES
Entity type:Organization
Organization Name:ELEVATE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-406-8222
Mailing Address - Street 1:229 JENKINS RANCH RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-9462
Mailing Address - Country:US
Mailing Address - Phone:315-406-8222
Mailing Address - Fax:970-844-1718
Practice Address - Street 1:29423 HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7939
Practice Address - Country:US
Practice Address - Phone:315-406-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech