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General NPI Number Information
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NPI Number | 1144976713
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Entity Type | Organization
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Legal Business Name | INSPIRED LIFE SERVICES LLC
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 1139 43RD ST
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City | NEWPORT NEWS
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State | VA
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Zip | 23607-2411
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Country | US
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Telephone | 757-540-8710
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Fax | 540-782-2238
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Provider Business Mailing Address
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Address Line | PO BOX 9654
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City | HAMPTON
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State | VA
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Zip | 23670-0654
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Country | US
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Telephone | 757-540-8710
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Fax | 757-782-2238
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TRACEY ADELE JOHNSON
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Credential | M.A., QDDP
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Telephone | 757-540-8710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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