| Elevate Ccbhc Llc | |
|
1410 W Dunkerton Rd Waterloo IA 50703-9648 | |
| (319) 423-9738 | |
| Not Available |
| Full Name | Elevate Ccbhc Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1410 W Dunkerton Rd, Waterloo, Iowa |
| Authorized Official Name and Position | Ilya Shulman (MANAGER) |
| Authorized Official Contact | 8474143847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevate Ccbhc Llc 7101 N Cicero Ave Ste 200 Lincolnwood IL 60712-2112 Ph: (224) 420-7133 | Elevate Ccbhc Llc 1410 W Dunkerton Rd Waterloo IA 50703-9648 Ph: (319) 423-9738 |
| NPI Number | 1275141350 |
|---|---|
| Provider Enumeration Date | 07/15/2020 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275141350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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