Provider Demographics
NPI:1922387786
Name:UPCAP SERVICES, INC.
Entity Type:Organization
Organization Name:UPCAP SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SERVICES MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-786-4701
Mailing Address - Street 1:2501 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1136
Mailing Address - Country:US
Mailing Address - Phone:906-786-4701
Mailing Address - Fax:906-786-8047
Practice Address - Street 1:2501 14TH AVE S
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1136
Practice Address - Country:US
Practice Address - Phone:906-786-4701
Practice Address - Fax:906-786-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4508819Medicaid
MI4509422Medicaid