Provider Demographics
NPI:1063144921
Name:HELPING OPPRESSED & MARGINALIZED COMMUNITIES TO ELEVATE INC.
Entity type:Organization
Organization Name:HELPING OPPRESSED & MARGINALIZED COMMUNITIES TO ELEVATE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRESTON
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-868-4948
Mailing Address - Street 1:750 S ORANGE BLOSSOM TRL STE 156
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-3159
Mailing Address - Country:US
Mailing Address - Phone:484-868-4948
Mailing Address - Fax:
Practice Address - Street 1:750 S ORANGE BLOSSOM TRL STE 156
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3159
Practice Address - Country:US
Practice Address - Phone:484-868-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty