Club Uplifted, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

CLUB UPLIFTED, INC

Practice address

30 N Washington St
Ypsilanti, MI 48197-3602

Phone

(734) 272-5768

Fax

(734) 879-0562

NPI assigned

Apr 20, 2023

Last updated

Apr 20, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Valory Brown

Title

President

Phone

(734) 272-5768

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1861189789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N WASHINGTON ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481973602",
            "telephone_number": "734-272-5768",
            "fax_number": "734-879-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N WASHINGTON ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481973602",
            "telephone_number": "734-272-5768",
            "fax_number": "734-879-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB UPLIFTED, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VALORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-272-5768"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eriona Cleveland
• Richard J Clews, ANP
• Amy Cline
• Zachary Clipper II
• Anita M Clos, LMSW
• Hannah Renee Coccia, RN
• Li Coger, O.M.D, LAC
• Evan Howard Cohen, PH.D.
• Judith Cohen, LMSW
• Douglas W. Cole, D.D.S.

• Developmentally Disabled Services Day Training Agency in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Developmentally Disabled Services Day Training Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.