Provider Demographics
NPI:1326934696
Name:UP & HALE LIVING LLC
Entity type:Organization
Organization Name:UP & HALE LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TITILAYO
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAKIRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-2087
Mailing Address - Street 1:13992 BALTIMORE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5010
Mailing Address - Country:US
Mailing Address - Phone:240-486-2087
Mailing Address - Fax:
Practice Address - Street 1:13992 BALTIMORE AVE STE 202
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5010
Practice Address - Country:US
Practice Address - Phone:240-486-2087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service