Organization
PROJECT UPLIFT LLC
Active
Other names
project uplift llc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALONZO HICKERSON (OWNER OPERATOR)
(775) 379-0748
Entity
Organization
Contact information
Practice address
5925 OMAHA ST, RENO, NV 89506-8813
(775) 379-0748
Mailing address
2300 HARVARD WAY # 105, RENO, NV 89502-4002
(775) 379-0748
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
C-2101
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619008281
—
NV
Enumeration date
11/09/2011
Last updated
11/09/2011
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