Provider Demographics
NPI:1326913559
Name:UPSTREAM
Entity type:Organization
Organization Name:UPSTREAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEDA-WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-238-2814
Mailing Address - Street 1:400 GOLD AVE SW STE 1300
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3274
Mailing Address - Country:US
Mailing Address - Phone:505-238-2814
Mailing Address - Fax:
Practice Address - Street 1:19 CIRQUELA ROAD
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008
Practice Address - Country:US
Practice Address - Phone:505-238-2814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KROSSROADS INTEGRATIVE HEALTH AND RECOVERY SOLUTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty