Provider Demographics
NPI:1154744548
Name:ELEVATION HOSPICE OF UTAH, LLC
Entity type:Organization
Organization Name:ELEVATION HOSPICE OF UTAH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRODDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-478-6830
Mailing Address - Street 1:11693 S 700 E STE 200
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7573
Mailing Address - Country:US
Mailing Address - Phone:801-610-1868
Mailing Address - Fax:801-642-2486
Practice Address - Street 1:11693 S 700 E STE 200
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7573
Practice Address - Country:US
Practice Address - Phone:801-610-1868
Practice Address - Fax:801-642-2486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based