Provider Demographics
NPI:1013338235
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 1:1011 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3411
Mailing Address - Country:US
Mailing Address - Phone:803-599-7910
Mailing Address - Fax:866-786-3576
Practice Address - Street 1:1011 EAST AVE
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3411
Practice Address - Country:US
Practice Address - Phone:803-599-7910
Practice Address - Fax:866-786-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5467101YM0800X
SC2565101YM0800X
SC91851041C0700X
SC32077207Q00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC154BHSMedicaid