Provider Demographics
NPI:1942497086
Name:UPSCALE RESIDENTIAL CARE, INC
Entity Type:Organization
Organization Name:UPSCALE RESIDENTIAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VENDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-789-1154
Mailing Address - Street 1:PO BOX 1051
Mailing Address - Street 2:
Mailing Address - City:ROSEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28382-1051
Mailing Address - Country:US
Mailing Address - Phone:919-789-1154
Mailing Address - Fax:866-786-3576
Practice Address - Street 1:614 NORTH MAPLE PLACE
Practice Address - Street 2:
Practice Address - City:ROSEBORO
Practice Address - State:NC
Practice Address - Zip Code:28382
Practice Address - Country:US
Practice Address - Phone:919-789-1154
Practice Address - Fax:866-786-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2565101YM0800X
SC5467101YM0800X
SC91451041C0700X
SC32077207Q00000X
NC251S00000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408037Medicaid
SC154BHSMedicaid