Healthcare Provider Details

I. General information

NPI: 1306421748
Provider Name (Legal Business Name): INSPIRE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 RIDGE VISTA AVE
SAN JOSE CA
95127-1501
US

IV. Provider business mailing address

401 RIDGE VISTA AVE
SAN JOSE CA
95127-1501
US

V. Phone/Fax

Practice location:
  • Phone: 408-923-7232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AMAN DHILLON
Title or Position: ADMINISTRATOR
Credential:
Phone: 408-923-7232