Provider Demographics
NPI:1063083806
Name:UPLIFT MENTAL HEALTH WELLNESS LLC
Entity type:Organization
Organization Name:UPLIFT MENTAL HEALTH WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:725-218-8921
Mailing Address - Street 1:170 S GREEN VALLEY PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-3145
Mailing Address - Country:US
Mailing Address - Phone:725-218-8921
Mailing Address - Fax:
Practice Address - Street 1:170 S GREEN VALLEY PKWY STE 300
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3145
Practice Address - Country:US
Practice Address - Phone:725-218-8921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)