Organization Name: | UPSIDE TO YOUTH DEVELOPMENT, LLC |
NPI Number: | 1356670178 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT E. GAY (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 943 Starling Ave Martinsville |
State: | VA US |
Postal Code: | 241126405 |
Phone Number: | 8045904453 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2009 |
NPI Last Update Date: | 12/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 1082-05-001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |