Provider Demographics
NPI:1306083688
Name:UPWARD CHANGE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:UPWARD CHANGE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-422-3036
Mailing Address - Street 1:2003 E NC HIGHWAY 54
Mailing Address - Street 2:SUITE C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2482
Mailing Address - Country:US
Mailing Address - Phone:919-682-5300
Mailing Address - Fax:919-682-5322
Practice Address - Street 1:2003 E NC HIGHWAY 54
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2482
Practice Address - Country:US
Practice Address - Phone:919-682-5300
Practice Address - Fax:919-682-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health