| Elevated Minds LLC | |
|
9701 Apollo Dr Ste 100 Largo MD 20774-4785 | |
| (240) 766-5295 | |
| Not Available |
| Full Name | Elevated Minds LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 9701 Apollo Dr Ste 100, Largo, Maryland |
| Authorized Official Name and Position | Leeshe Grimes (CEO) |
| Authorized Official Contact | 2024200227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevated Minds LLC 9701 Apollo Dr Ste 100 Largo MD 20774-4785 Ph: (240) 766-5295 | Elevated Minds LLC 9701 Apollo Dr Ste 100 Largo MD 20774-4785 Ph: (240) 766-5295 |
| NPI Number | 1518586049 |
|---|---|
| Provider Enumeration Date | 04/14/2020 |
| Last Update Date | 04/14/2020 |
| Certification Date | 04/14/2020 |
| Medicare PECOS PAC ID | 3678078748 |
|---|---|
| Medicare Enrollment ID | O20250929000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518586049 | NPI | - | NPPES |
| NA | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
| Provider Name | Leeshe Grimes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669982633 PECOS PAC ID: 5496250565 Enrollment ID: I20250929000654 |
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