| Elevation Therapy Group LLC | |
|
1110 Benfield Blvd Ste H Millersville MD 21108-2644 | |
| (443) 845-0012 | |
| (443) 276-2800 |
| Full Name | Elevation Therapy Group LLC |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1110 Benfield Blvd Ste H, Millersville, Maryland |
| Authorized Official Name and Position | Adam L Iacarino (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4438450012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevation Therapy Group LLC 8940 Old Annapolis Rd Ste E Columbia MD 21045-2129 Ph: (443) 845-0012 | Elevation Therapy Group LLC 1110 Benfield Blvd Ste H Millersville MD 21108-2644 Ph: (443) 845-0012 |
| NPI Number | 1265016539 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 12/28/2022 |
| Certification Date | 12/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265016539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
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