Provider Demographics
NPI:1730350372
Name:UPLIFT COMPREHENSIVE SERVICES
Entity type:Organization
Organization Name:UPLIFT COMPREHENSIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-334-1536
Mailing Address - Street 1:PO BOX 1408
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27906-1408
Mailing Address - Country:US
Mailing Address - Phone:252-334-1536
Mailing Address - Fax:
Practice Address - Street 1:150 E ARLINGTON BLVD
Practice Address - Street 2:SUITE F.
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5019
Practice Address - Country:US
Practice Address - Phone:252-551-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty