Provider Demographics
NPI:1104235662
Name:C. UPSHAW & ASSOCIATES CONSULTING
Entity type:Organization
Organization Name:C. UPSHAW & ASSOCIATES CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:UPSHAW
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:734-444-4985
Mailing Address - Street 1:4020 16TH ST
Mailing Address - Street 2:
Mailing Address - City:ECORSE
Mailing Address - State:MI
Mailing Address - Zip Code:48229-1357
Mailing Address - Country:US
Mailing Address - Phone:734-444-4985
Mailing Address - Fax:
Practice Address - Street 1:4020 16TH ST
Practice Address - Street 2:
Practice Address - City:ECORSE
Practice Address - State:MI
Practice Address - Zip Code:48229-1357
Practice Address - Country:US
Practice Address - Phone:734-444-4985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-09
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251B00000X
MI4704255523251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management