Provider Demographics
NPI:1619205218
Name:UPTOWN WELLNESS CENTER
Entity Type:Organization
Organization Name:UPTOWN WELLNESS CENTER
Other - Org Name:HOWARDS ENTERPRISE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-667-7707
Mailing Address - Street 1:212 CORCORAN STRRET
Mailing Address - Street 2:SUITE 216
Mailing Address - City:DURHAM
Mailing Address - State:NORTH CAROLINA
Mailing Address - Zip Code:27701
Mailing Address - Country:UM
Mailing Address - Phone:919-884-8778
Mailing Address - Fax:919-687-0506
Practice Address - Street 1:212 CORCORAN STREET
Practice Address - Street 2:SUITE 216
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3210
Practice Address - Country:US
Practice Address - Phone:919-884-8778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty