Healthcare Provider Details

I. General information

NPI: 1508918517
Provider Name (Legal Business Name): INSPIRED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 W LAUREL RD
LONDON KY
40741-9709
US

IV. Provider business mailing address

PO BOX 2454
LONDON KY
40743-2454
US

V. Phone/Fax

Practice location:
  • Phone: 606-877-1552
  • Fax: 606-877-1594
Mailing address:
  • Phone: 606-877-1552
  • Fax: 606-877-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number33001298
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number33001298
License Number StateKY

VIII. Authorized Official

Name: MR. MICHAEL NAPIER
Title or Position: MEMBER
Credential:
Phone: 606-877-1552