Healthcare Provider Details

I. General information

NPI: 1477521730
Provider Name (Legal Business Name): UPWARD FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6306 N 7TH ST
PHOENIX AZ
85014
US

IV. Provider business mailing address

6306 N 7TH ST
PHOENIX AZ
85014
US

V. Phone/Fax

Practice location:
  • Phone: 602-279-5801
  • Fax: 602-279-0785
Mailing address:
  • Phone: 602-279-5801
  • Fax: 602-279-0785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JACK NEVINS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 602-279-5801