ELEVATE CCBHC LLC NPI 1275141350

NPI Information

  • NPI: 1275141350
  • Provider Name: ELEVATE CCBHC LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • CLIA Number: 16D2194115
  • Address: 1410 W DUNKERTON RD
    WATERLOO, IA
    ZIP 50703
  • Phone: (319) 423-9738

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NPI Details

ELEVATE CCBHC LLC is a mental health (including community mental health center) clinic center in Waterloo, IA. ELEVATE CCBHC LLC NPI is 1275141350. The provider is registered as an organization entity type.

The provider's business location address is:

1410 W DUNKERTON RD
WATERLOO, IA
ZIP 50703-648
Phone: (319) 423-9738

The provider's authorized official is Ilya Shulman .
The authorized official title is Manager and has the following contact phone number (847) 414-3847.

The CLIA number assigned to this NPI record is 16D2194115 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2020 and was last updated on 7/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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