Provider Demographics
NPI:1902498751
Name:ELEVATING HOME HEALTH CARE
Entity Type:Organization
Organization Name:ELEVATING HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JO-VEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:JERNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-348-5029
Mailing Address - Street 1:5040 VIRGINIA BEACH BLVD STE 104B
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6637
Mailing Address - Country:US
Mailing Address - Phone:757-348-5029
Mailing Address - Fax:845-790-6400
Practice Address - Street 1:5040 VIRGINIA BEACH BLVD STE 104B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6637
Practice Address - Country:US
Practice Address - Phone:757-376-5450
Practice Address - Fax:845-790-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health