Organization
ELEVATE YOUTH SERVICES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAVOR ELLIS (EXECUTIVE DIRECTOR)
(802) 229-9151
Entity
Organization
Contact information
Practice address
652 GRANGER RD STE 2, BARRE, VT 05641-5363
(802) 229-9151
Mailing address
652 GRANGER RD STE 2, BARRE, VT 05641-5363
(802) 229-9151
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004380
—
VT
05
—
1010291
—
VT
05
—
1010292
—
VT
Enumeration date
07/16/2013
Last updated
11/25/2024
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