Organization
UPLIFT SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS THOMAS POWELL (CEO)
(813) 803-0315
Entity
Organization
Contact information
Practice address
4415 FLORIDA NATIONAL DR STE 108, LAKELAND, FL 33813-1567
(813) 803-0315
Mailing address
4415 FLORIDA NATIONAL DR STE 108, LAKELAND, FL 33813-1567
(813) 803-0315
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
L16000017965
FL
Other
Enumeration date
09/30/2016
Last updated
04/13/2018
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