Provider Demographics
NPI:1023779543
Name:ELEVATE BRANSON
Entity type:Organization
Organization Name:ELEVATE BRANSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-294-1300
Mailing Address - Street 1:1440 STATE HIGHWAY 248 STE Q-442
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-9655
Mailing Address - Country:US
Mailing Address - Phone:417-294-1300
Mailing Address - Fax:
Practice Address - Street 1:1440 STATE HIGHWAY 248 STE Q-442
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-9655
Practice Address - Country:US
Practice Address - Phone:417-294-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251B00000XAgenciesCase Management