Provider Demographics
NPI:1073940789
Name:UP TRANSFORMATIONS LLC
Entity Type:Organization
Organization Name:UP TRANSFORMATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:AALTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-748-0060
Mailing Address - Street 1:1100 LUDINGTON ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-3542
Mailing Address - Country:US
Mailing Address - Phone:906-399-5704
Mailing Address - Fax:
Practice Address - Street 1:1100 LUDINGTON ST
Practice Address - Street 2:SUITE 206
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-3542
Practice Address - Country:US
Practice Address - Phone:906-399-5704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801091424302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization