MEDICARE: UPLIFTING HANDS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1639379845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPLIFTING HANDS LLC

Provider Business Mailing Address
First Line	:	2040 JARRETT DR
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27803-3749
Country	:	US
Telephone Number	:	252-977-2724
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 JARRETT DR
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27803-3749
Country	:	US
Telephone Number	:	252-977-2724
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MS. TERESA LAJUNE RISIEN
Credential	:
Telephone Number	:	252-977-2724

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/25/2007

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