Healthcare Provider Details

I. General information

NPI: 1265296529
Provider Name (Legal Business Name): INSPIRATION CASE MANAGEMENT AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 VETERANS MEMORIAL HWY SE
MABLETON GA
30126-7707
US

IV. Provider business mailing address

1238 COTTAGE BLVD
ATHENS GA
30605-4914
US

V. Phone/Fax

Practice location:
  • Phone: 678-818-2116
  • Fax:
Mailing address:
  • Phone: 678-818-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMARA A MOORE
Title or Position: CEO
Credential: MSW
Phone: 678-818-2116