Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health or Welfare |
251K00000X | 60 | Public Health or Welfare Agency |
| NPI Number | 1295554996 |
| LBN Legal business name | ELEVATE YOUTH SERVICES INCORPORATED |
| Authorized official | FAVOR ELLIS - (EXECUTIVE DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/09/2024 |
| Last updated | 10/09/2024 - More than a year ago |
| Identifiers | n/a |
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