MEDICARE: UPLIFT COMMUNITY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1457135907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPLIFT COMMUNITY SERVICES INC

Provider Business Mailing Address
First Line	:	8313 SOUTHWEST FWY STE 233
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1656
Country	:	US
Telephone Number	:	919-451-8530
Fax Number	:

Provider Business Practice Location Address
First Line	:	8313 SOUTHWEST FWY STE 233
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1656
Country	:	US
Telephone Number	:	919-451-8530
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN BRASWELL
Credential	:
Telephone Number	:	919-451-8530

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	12/31/2024

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