Healthcare Provider Details

I. General information

NPI: 1700792439
Provider Name (Legal Business Name): LIFT RECOVERY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 STONY POINT TRL
WEBSTER NY
14580-1323
US

IV. Provider business mailing address

201 STONY POINT TRL
WEBSTER NY
14580-1323
US

V. Phone/Fax

Practice location:
  • Phone: 585-576-9276
  • Fax:
Mailing address:
  • Phone: 585-576-9276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIE MARKS
Title or Position: OWNER
Credential:
Phone: 585-576-9276