Organization
ELEVATE PREMIER SUPPORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MORUFU FAGBENRO OWNER (DIRECTOR)
(443) 627-1654
Entity
Organization
Contact information
Practice address
1332 LONDONTOWN BLVD STE 115H, ELDERSBURG, MD 21784-6587
(443) 627-1654
Mailing address
1332 LONDONTOWN BLVD STE 115H, ELDERSBURG, MD 21784-6587
(443) 627-1654
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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