Healthcare Provider Details
I. General information
NPI: 1831968874
Provider Name (Legal Business Name): INSPIRE WELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/01/2024
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
221 LISBON ST # 3
LISBON ME
04250-6021
US
IV. Provider business mailing address
31 CHAMPAGNE LN
LISBON ME
04250-6078
US
V. Phone/Fax
- Phone: 603-568-3752
- Fax:
- Phone: 603-568-3752
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDRE
BIRENZI
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 603-568-3752