Healthcare Provider Details

I. General information

NPI: 1154703320
Provider Name (Legal Business Name): JFM INSPIRATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 N 24TH PL
PHOENIX AZ
85008-4910
US

IV. Provider business mailing address

4119 N MITCHELL ST
PHOENIX AZ
85014-4815
US

V. Phone/Fax

Practice location:
  • Phone: 480-343-0086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberBH4621
License Number StateAZ

VIII. Authorized Official

Name: ALISA FURCH
Title or Position: CLINICAL COORDINATOR
Credential: LPC
Phone: 602-299-3545