Organization
ELEVATED HEALING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN BIRD (MANAGER)
(630) 364-8144
Entity
Organization
Contact information
Practice address
1600 JOHN ADAMS PKWY STE 101, IDAHO FALLS, ID 83401-4300
(208) 716-5063
(866) 661-4322
Mailing address
427 SUNTERRA DR, IDAHO FALLS, ID 83404-5090
(630) 364-8144
(866) 661-4322
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
09/09/2025
Last updated
10/07/2025
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