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Organization
LIFT UP YOUR HEAD THERAPEUTIC GROUP HOMES, INC.
Active
Organization
LIFT UP YOUR HEAD THERAPEUTIC GROUP HOMES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YOLANDA A JOHNSON I EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(951) 634-5570
Entity
Organization
Contact information
Practice address
786 BROOKHURST BLVD, LATHROP, CA 95330-8984
(209) 983-8633
Mailing address
786 BROOKHURST BLVD, LATHROP, CA 95330-8984
(209) 983-8633
(209) 323-4452
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/02/2021
Last updated
01/02/2021
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