Provider Demographics
NPI:1063473866
Name:UPLIFT, INC
Entity type:Organization
Organization Name:UPLIFT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:P
Authorized Official - Last Name:KINNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-582-8021
Mailing Address - Street 1:25 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-1905
Mailing Address - Country:US
Mailing Address - Phone:207-582-8021
Mailing Address - Fax:207-582-2457
Practice Address - Street 1:25 WINTER ST
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04345-1905
Practice Address - Country:US
Practice Address - Phone:207-582-8021
Practice Address - Fax:207-582-2457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services