Provider Demographics
NPI:1063015493
Name:UPREACH, LLC
Entity Type:Organization
Organization Name:UPREACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SELBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-378-4833
Mailing Address - Street 1:4488 MOBILE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3713
Mailing Address - Country:US
Mailing Address - Phone:614-442-7702
Mailing Address - Fax:
Practice Address - Street 1:4488 MOBILE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3713
Practice Address - Country:US
Practice Address - Phone:614-442-7702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2397455Medicaid