Organization
ELEVATE360 SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE LANE MA, (EXECUTIVE DIRECTOR)
(678) 677-4041
Entity
Organization
Contact information
Practice address
10707 CORPORATE DR STE 250, STAFFORD, TX 77477-4037
(678) 677-4041
Mailing address
3627 CIBOLO CT, PEARLAND, TX 77584-3975
(678) 677-4041
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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