Organization
LIFT UP YOUR HEAD THERAPEUTIC GROUP HOMES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YOLANDA A JOHNSON I EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(951) 634-5570
Entity
Organization
Contact information
Practice address
786 BROOKHURST BLVD, LATHROP, CA 95330-8984
(209) 983-8633
Mailing address
786 BROOKHURST BLVD, LATHROP, CA 95330-8984
(209) 983-8633
(209) 323-4452
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/02/2021
Last updated
01/02/2021
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