Healthcare Provider Details

I. General information

NPI: 1083987564
Provider Name (Legal Business Name): BE INSPIRED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W SILVER SPRING DR STE K200
MILWAUKEE WI
53217-5051
US

IV. Provider business mailing address

500 W SILVER SPRING DR STE K200
MILWAUKEE WI
53217-5051
US

V. Phone/Fax

Practice location:
  • Phone: 414-847-6258
  • Fax: 414-376-6336
Mailing address:
  • Phone: 414-847-6258
  • Fax: 414-376-6336

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENNA TRIGGS
Title or Position: EXECUTIVE DIRECTOR
Credential: BA
Phone: 414-847-6258