Provider Demographics
NPI:1801595194
Name:ELEVATE HEALTHCARE LLC
Entity type:Organization
Organization Name:ELEVATE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC MSW LPN
Authorized Official - Phone:719-470-1415
Mailing Address - Street 1:212 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3754
Mailing Address - Country:US
Mailing Address - Phone:719-470-1415
Mailing Address - Fax:
Practice Address - Street 1:212 W 13TH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3754
Practice Address - Country:US
Practice Address - Phone:719-470-1415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2542-01OtherSTATE OF COLORADO SUD
CO308OtherSTATE OF COLORADO CONTROLLED SUBSTANCE