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Organization
UPLIFT DYNAMICS LLC
Active
Organization
UPLIFT DYNAMICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL FOWLER (CEO)
(843) 472-7401
Entity
Organization
Contact information
Practice address
20 DESIGNER ST, KINGSTREE, SC 29556-5004
(843) 472-7401
Mailing address
20 DESIGNER ST, KINGSTREE, SC 29556-5004
(843) 472-7401
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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