Lift Up Your Head Therapeutic Group Homes, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

LIFT UP YOUR HEAD THERAPEUTIC GROUP HOMES, INC.

Practice address

786 Brookhurst Blvd
Lathrop, CA 95330-8984

Phone

(209) 983-8633

NPI assigned

Jan 2, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Yolanda A Johnson I, EXECUTIVE DIRECTOR

Title

Executive Director

Phone

(951) 634-5570

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dwayne Raynard White

  • Case Manager/Care Coordinator
  • Lathrop, CA
  • NPI 1548979552
  NPD

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

{
    "created_epoch": "1609545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609545600000",
    "number": "1972191385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 BROOKHURST BLVD",
            "city": "LATHROP",
            "state": "CA",
            "postal_code": "953308984",
            "telephone_number": "209-983-8633",
            "fax_number": "209-323-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 BROOKHURST BLVD",
            "city": "LATHROP",
            "state": "CA",
            "postal_code": "953308984",
            "telephone_number": "209-983-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFT UP YOUR HEAD THERAPEUTIC GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-02",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "951-634-5570",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "EXECUTIVE DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lathrop Urgent Care, a Professional Medical Corporation
• Lathrop-Manteca Fire Protection District
• Renetta Marie Lee, CMT#99713
• Jennifer Leung
• Jenny Shaw Li, L.AC, PH.D
• Grace Lin
• Ragnar Lindberg, AUD
• Maria Lujan
• Sharanjit Kaur Mand, DDS
• Kanwaldeep Mann, MD

• All providers in Lathrop, CA
• Emotionally Disturbed Childrens' Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; 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.