Provider Demographics
NPI:1063166775
Name:THE UPLIFTCO LIMITED
Entity type:Organization
Organization Name:THE UPLIFTCO LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REESE
Authorized Official - Middle Name:LAMOUNTE
Authorized Official - Last Name:THOMAS-MCDADE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:702-738-3185
Mailing Address - Street 1:9627 GRAPELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4206
Mailing Address - Country:US
Mailing Address - Phone:702-738-3185
Mailing Address - Fax:
Practice Address - Street 1:9627 GRAPELAND AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4206
Practice Address - Country:US
Practice Address - Phone:702-738-3185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health