Basic Information
| Provider Information | |||||||||
| NPI: | 1922428739 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ELEVATE HOME HEALTH, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | OASIS HOME HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27071 ALISO CREEK RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ALISO VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926565327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493491200 | ||||||||
| FaxNumber: | 9493491122 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 E CHARLESTON BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891041545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023823030 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2014 | ||||||||
| LastUpdateDate: | 04/18/2014 | ||||||||
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| AuthorizedOfficialLastName: | SPARKS | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF REIMBURSEMENT | ||||||||
| AuthorizedOfficialTelephone: | 9493491200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 6271HHA-3 | NV | Y | Agencies | Home Health |
No ID Information.