Provider Demographics
NPI:1851087308
Name:UPLIFT KIDZ, INC
Entity Type:Organization
Organization Name:UPLIFT KIDZ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENOVIEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-302-8111
Mailing Address - Street 1:213 DEERPATH RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-7509
Mailing Address - Country:US
Mailing Address - Phone:972-302-8111
Mailing Address - Fax:
Practice Address - Street 1:2300 HIGHLAND VILLAGE RD STE 810
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7195
Practice Address - Country:US
Practice Address - Phone:972-302-8111
Practice Address - Fax:972-499-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty