Organization
BLACK ELEPHANT WELLNESS CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMILA PROVITT (OWNER)
(216) 626-7648
Entity
Organization
Contact information
Practice address
5589 DUNHAM RD, MAPLE HEIGHTS, OH 44137-3657
(216) 626-7648
Mailing address
5589 DUNHAM RD, MAPLE HEIGHTS, OH 44137-3657
(216) 626-7648
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/28/2026
Last updated
02/28/2026
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