Provider Demographics
NPI:1033933023
Name:UPLIFT THE HUMAN SPIRIT
Entity type:Organization
Organization Name:UPLIFT THE HUMAN SPIRIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-684-3182
Mailing Address - Street 1:PO BOX 692741
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95269-2741
Mailing Address - Country:US
Mailing Address - Phone:209-684-3182
Mailing Address - Fax:
Practice Address - Street 1:1743 GRAND CANAL BLVD STE 17
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-8108
Practice Address - Country:US
Practice Address - Phone:209-451-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage