Provider Demographics
NPI:1568746162
Name:FAMILY UPLIFT, INC.
Entity Type:Organization
Organization Name:FAMILY UPLIFT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-653-8354
Mailing Address - Street 1:1299 BATTLECREEK RD
Mailing Address - Street 2:STE. 230
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-7981
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1299 BATTLECREEK RD
Practice Address - Street 2:STE. 230
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-7981
Practice Address - Country:US
Practice Address - Phone:770-471-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-01
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health