# LIFTED FOUNDATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710398250
- **Authorized official:** MS. TANYATTA CHATEAU LCSW (CLINICAL SOCIAL WORKER/ MANAGER)
- **Authorized official phone:** (818) 606-9836

## Contact information

- **Practice address:** 8363 RESEDA BLVD, SUITE 203 E, NORTHRIDGE, CA 91324-4623
- **Practice address phone:** (818) 727-7742
- **Mailing address:** 8363 RESEDA BLVD, SUITE 203 E, NORTHRIDGE, CA 91324-4623
- **Mailing address phone:** (818) 727-7742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | LCS 23309 | CA | Yes |
| 251S00000X | Community/Behavioral Health Agency | LCS 23309 | CA | — |

## Other

- **Enumeration date:** 05/19/2014
- **Last updated:** 11/05/2014