Provider Demographics
NPI:1649700824
Name:UPLIFT TRAINING CENTER
Entity type:Organization
Organization Name:UPLIFT TRAINING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, LMSW
Authorized Official - Phone:804-840-3550
Mailing Address - Street 1:10300 E 81ST ST
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-2110
Mailing Address - Country:US
Mailing Address - Phone:804-840-3550
Mailing Address - Fax:
Practice Address - Street 1:2708 W 43RD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3125
Practice Address - Country:US
Practice Address - Phone:913-708-8247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS12166OtherSTATE OF KANSAS BSRB LMSW