Healthcare Provider Details

I. General information

NPI: 1629996939
Provider Name (Legal Business Name): UP NEXT DIRECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 W 165TH ST
COMPTON CA
90220-4315
US

IV. Provider business mailing address

400 CONTINENTAL BLVD STE 6084
EL SEGUNDO CA
90245-5076
US

V. Phone/Fax

Practice location:
  • Phone: 323-353-8154
  • Fax:
Mailing address:
  • Phone: 323-353-8154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TAMELA BONESHA BEAVERS
Title or Position: OWNER
Credential:
Phone: 323-353-8154