Organization
UPLIFTING CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTIN NTEZEYOMBI (CEO)
(480) 845-3154
Entity
Organization
Contact information
Practice address
9434 W MEADOWBROOK AVE, PHOENIX, AZ 85037-2398
(480) 845-3154
Mailing address
9434 W MEADOWBROOK AVE, PHOENIX, AZ 85037-2398
(480) 845-3154
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH7457
AZDHS
AZ
Enumeration date
05/23/2022
Last updated
05/23/2022
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