Provider Demographics
NPI:1578395877
Name:FOUNDATION FOR ELEVATION LLC
Entity type:Organization
Organization Name:FOUNDATION FOR ELEVATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:LASHAE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-255-3157
Mailing Address - Street 1:11329 CEDAR RUN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23805-4105
Mailing Address - Country:US
Mailing Address - Phone:804-255-3157
Mailing Address - Fax:
Practice Address - Street 1:224 N MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2700
Practice Address - Country:US
Practice Address - Phone:804-255-3157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty