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General NPI Number Information
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NPI Number | 1407602261
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Entity Type | Organization
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Legal Business Name | UPTREAM LIVING SOLUTIONS & MOBILE THERAPY LLC
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 511 SUNRISE BLVD N
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City | TWIN FALLS
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State | ID
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Zip | 83301-4350
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Country | US
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Telephone | 208-421-6775
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Fax |
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Provider Business Mailing Address
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Address Line | 511 SUNRISE BLVD N
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City | TWIN FALLS
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State | ID
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Zip | 83301-4350
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Country | US
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Telephone | 208-421-6775
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Fax |
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Authorized Official
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Title or Position | OT
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Name | DANIEL ALDAMA
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Credential | OTR/L, CAPS, ECHM
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Telephone | 208-421-9775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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