Elevate Ccbhc LLC

NPI #1275141350 in Waterloo, Iowa

Provider Information

NPI Number: 1275141350
Entity Type: Organization
Organization Name: Elevate Ccbhc LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jul 15, 2020
Last Updated: Jul 15, 2020

Practice Location

Address: 1410 W DUNKERTON RD
City: Waterloo
State: Iowa
ZIP Code: 50703-9648
Phone: (319) 423-9738

Authorized Official

Name: ILYA SHULMAN
Title: MANAGER
Phone: (847) 414-3847

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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