Provider Demographics
NPI:1407548464
Name:UPLIFT COMMUNITY LLC
Entity Type:Organization
Organization Name:UPLIFT COMMUNITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FOZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-491-3819
Mailing Address - Street 1:4333 15TH AVE S APT 324
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3356
Mailing Address - Country:US
Mailing Address - Phone:701-491-3819
Mailing Address - Fax:
Practice Address - Street 1:4333 15TH AVE S APT 324
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3356
Practice Address - Country:US
Practice Address - Phone:701-491-3819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care