Provider Demographics
NPI:1104633353
Name:UPWARDS JOURNEY LLC
Entity type:Organization
Organization Name:UPWARDS JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINBOHUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-265-7734
Mailing Address - Street 1:4720 E PORTOLA VALLEY DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-2474
Mailing Address - Country:US
Mailing Address - Phone:480-265-7734
Mailing Address - Fax:
Practice Address - Street 1:4720 E PORTOLA VALLEY DR UNIT 102
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2474
Practice Address - Country:US
Practice Address - Phone:480-265-7734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health