Healthcare Provider Details

I. General information

NPI: 1528292067
Provider Name (Legal Business Name): INSPIRATIONS EARLY INTERVENTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 10/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 PHOENIX AVE NE SUITE 709
ALBUQUERQUE NM
87110-3548
US

IV. Provider business mailing address

7010 PHOENIX AVE NE SUITE 709
ALBUQUERQUE NM
87110-3548
US

V. Phone/Fax

Practice location:
  • Phone: 505-550-2643
  • Fax:
Mailing address:
  • Phone: 505-550-2643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN MARIE GRIMM LUCERO
Title or Position: PRESIDENT/CHIEF EXECUTIVE OFFICER
Credential: P.T.
Phone: 505-550-2643