Organization
ELEVATE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
URSULA HOLLINS LAC MSW LPN (EXECUTIVE DIRECTOR)
(719) 470-1415
Entity
Organization
Contact information
Practice address
212 W 13TH ST, PUEBLO, CO 81003-3754
(719) 470-1415
Mailing address
212 W 13TH ST, PUEBLO, CO 81003-3754
(719) 470-1415
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2542-01
STATE OF COLORADO SUD
CO
01
—
308
STATE OF COLORADO CONTROLLED SUBSTANCE
CO
Enumeration date
02/27/2023
Last updated
02/27/2023
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