Healthcare Provider Details

I. General information

NPI: 1073081014
Provider Name (Legal Business Name): INSPIRED HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7833 CALIBRE CROSSING DR APT 205
CHARLOTTE NC
28227-6780
US

IV. Provider business mailing address

7833 CALIBRE CROSSING DR APT 205
CHARLOTTE NC
28227-6780
US

V. Phone/Fax

Practice location:
  • Phone: 910-207-1729
  • Fax:
Mailing address:
  • Phone: 910-207-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BELINDA YVETTE MARTIN
Title or Position: OWNER
Credential: NCPSS
Phone: 910-207-1729