Healthcare Provider Details
I. General information
NPI: 1881714475
Provider Name (Legal Business Name): INSPIRATION FIELD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2007
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
612 ADAMS AVE
LA JUNTA CO
81050-2535
US
IV. Provider business mailing address
612 ADAMS AVE
LA JUNTA CO
81050-2535
US
V. Phone/Fax
- Phone: 719-384-8741
- Fax: 719-384-4278
- Phone: 719-384-8741
- Fax: 719-384-4278
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROSA
M
SALO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 719-384-8741