# LIFT UP YOUR HEAD THERAPEUTIC GROUP HOMES, INC.

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

## Provider details

- **NPI number:** 1972191385
- **Authorized official:** MRS. YOLANDA A JOHNSON I EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (951) 634-5570

## Contact information

- **Practice address:** 786 BROOKHURST BLVD, LATHROP, CA 95330-8984
- **Practice address phone:** (209) 983-8633
- **Mailing address:** 786 BROOKHURST BLVD, LATHROP, CA 95330-8984
- **Mailing address phone:** (209) 983-8633
- **Mailing address fax:** (209) 323-4452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 01/02/2021
- **Last updated:** 01/02/2021