Provider Demographics
NPI:1689996787
Name:UPLIFTING THE COMMUNITY, INC
Entity Type:Organization
Organization Name:UPLIFTING THE COMMUNITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERWAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-684-0868
Mailing Address - Street 1:1151 CLEVELAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-3600
Mailing Address - Country:US
Mailing Address - Phone:404-684-0868
Mailing Address - Fax:404-684-0871
Practice Address - Street 1:724 LAUREN PKWY
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3482
Practice Address - Country:US
Practice Address - Phone:678-510-7220
Practice Address - Fax:678-510-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00220107251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health