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Organization
ELEVATE LLC
Active
Organization
ELEVATE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES RICHARD HENLEY (CEO)
(401) 287-8302
Entity
Organization
Contact information
Practice address
333 MAIN ST STE 1, EAST GREENWICH, RI 02818-3660
(401) 447-2369
Mailing address
79 SEACREST LN, WARWICK, RI 02889-5453
(401) 447-2369
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
NULL
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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