Provider Demographics
NPI:1215240858
Name:UPLIFT COMPREHENSIVE SERVICES
Entity type:Organization
Organization Name:UPLIFT COMPREHENSIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:252-334-1536
Mailing Address - Street 1:PO BOX 1408
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27906-1408
Mailing Address - Country:US
Mailing Address - Phone:252-334-1536
Mailing Address - Fax:
Practice Address - Street 1:1004 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6427
Practice Address - Country:US
Practice Address - Phone:252-334-1536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health