Provider Demographics
NPI:1053913590
Name:LIFE ELEVATIONS CARE SERVICES LLC
Entity type:Organization
Organization Name:LIFE ELEVATIONS CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-230-4547
Mailing Address - Street 1:1270 S CLEVELAND MASSILLON RD STE A109
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1683
Mailing Address - Country:US
Mailing Address - Phone:330-957-9226
Mailing Address - Fax:
Practice Address - Street 1:1270 S CLEVELAND MASSILLON RD STE A109
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1683
Practice Address - Country:US
Practice Address - Phone:330-957-9226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)