Provider Demographics
NPI:1053199281
Name:ELEVATION HOME CARE INC
Entity type:Organization
Organization Name:ELEVATION HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MUTHONI
Authorized Official - Last Name:MAIMBA
Authorized Official - Suffix:
Authorized Official - Credentials:ADM
Authorized Official - Phone:253-238-0547
Mailing Address - Street 1:4904 70TH AVE W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-3230
Mailing Address - Country:US
Mailing Address - Phone:235-238-0547
Mailing Address - Fax:253-238-0260
Practice Address - Street 1:4904 70TH AVE W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-3230
Practice Address - Country:US
Practice Address - Phone:235-238-0547
Practice Address - Fax:253-238-0260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care