Provider Demographics
NPI:1093821233
Name:UPLIFT HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:UPLIFT HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAMURIC
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:818-884-5318
Mailing Address - Street 1:20121 VENTURA BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2559
Mailing Address - Country:US
Mailing Address - Phone:818-884-5318
Mailing Address - Fax:818-610-8932
Practice Address - Street 1:20121 VENTURA BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2546
Practice Address - Country:US
Practice Address - Phone:818-884-5318
Practice Address - Fax:818-610-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233-9854-8251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058305Medicare PIN