Provider Demographics
NPI:1902677818
Name:UPSCALE SERVICES OF GEORGIA LLC
Entity Type:Organization
Organization Name:UPSCALE SERVICES OF GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-340-3766
Mailing Address - Street 1:600 WESTRIDGE PKWY STE 714
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-7789
Mailing Address - Country:US
Mailing Address - Phone:866-340-3766
Mailing Address - Fax:888-312-7114
Practice Address - Street 1:600 WESTRIDGE PKWY STE 714
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-7789
Practice Address - Country:US
Practice Address - Phone:866-340-3766
Practice Address - Fax:888-312-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care