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General NPI Number Information
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NPI Number | 1295499648
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Entity Type | Organization
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Legal Business Name | UPLIFT 100 LLC
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 5212 VILLAGE CREEK DR # A
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City | PLANO
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State | TX
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Zip | 75093-5066
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Country | US
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Telephone | 972-773-9610
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Fax | 972-863-9686
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Provider Business Mailing Address
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Address Line | 2365 APOLLO ST 924
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City | GARLAND
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State | TX
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Zip | 75044-6332
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Country | US
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Telephone | 914-671-3855
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Fax |
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Authorized Official
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Title or Position | OPERATIONS
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Name | PA MUSA NYANG
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Credential |
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Telephone | 914-671-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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