Provider Demographics
NPI:1457992463
Name:ELEVATE TO ACHIEVE LLC
Entity type:Organization
Organization Name:ELEVATE TO ACHIEVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-605-9865
Mailing Address - Street 1:1208 E KENNEDY BLVD UNIT 912
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1208 E KENNEDY BLVD UNIT 912
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3537
Practice Address - Country:US
Practice Address - Phone:412-605-9865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health