Basic Information
| Provider Information | |||||||||
| NPI: | 1720424682 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PROJECT UPLIFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 SELMI DR | ||||||||
| Address2: | SUITE 601 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895126701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754205396 | ||||||||
| FaxNumber: | 7754205053 | ||||||||
| Practice Location | |||||||||
| Address1: | 1130 SELMI DR | ||||||||
| Address2: | SUITE 601 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895126701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754205396 | ||||||||
| FaxNumber: | 7754205053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2013 | ||||||||
| LastUpdateDate: | 05/20/2013 | ||||||||
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| AuthorizedOfficialLastName: | ROSS | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | GENERAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7754205396 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3104A0625X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
No ID Information.