Healthcare Provider Details

I. General information

NPI: 1629793682
Provider Name (Legal Business Name): INSPIRE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 S 51ST ST STE 101
PHOENIX AZ
85044-5216
US

IV. Provider business mailing address

10201 S 51ST ST STE 101
PHOENIX AZ
85044-5216
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-0900
  • Fax: 928-440-5057
Mailing address:
  • Phone: 602-258-0900
  • Fax: 602-258-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEANNA PETROV
Title or Position: COO
Credential:
Phone: 602-258-0900