Healthcare Provider Details

I. General information

NPI: 1982561825
Provider Name (Legal Business Name): UPLIFT BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 QUINCY ST
BROCKTON MA
02302-2926
US

IV. Provider business mailing address

201 QUINCY ST
BROCKTON MA
02302-2926
US

V. Phone/Fax

Practice location:
  • Phone: 508-313-9994
  • Fax: 617-586-1102
Mailing address:
  • Phone: 508-313-9994
  • Fax: 617-586-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONNA MARIE JOHNSON
Title or Position: CEO
Credential:
Phone: 508-313-9994