Provider Demographics
NPI:1811387111
Name:UPWARD CHANGE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:UPWARD CHANGE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:919-682-5300
Mailing Address - Street 1:2314 S MIAMI BLVD STE 154
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5796
Mailing Address - Country:US
Mailing Address - Phone:919-682-5300
Mailing Address - Fax:919-682-5322
Practice Address - Street 1:215 W ANTRIM DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2329
Practice Address - Country:US
Practice Address - Phone:919-422-3036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health