Organization
UPWARD CHANGE HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATASHA MACHELLE-KELLY SMITH LCSW-A (TEAM LEAD, CLINICAL THERAPIST)
(910) 778-3049
Entity
Organization
Contact information
Practice address
807 E MAIN ST, APT 2931, DURHAM, NC 27701-4074
(919) 682-5300
Mailing address
807 E MAIN ST, DURHAM, NC 27701-4074
(919) 682-5300
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
P007600
NC
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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