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General NPI Number Information
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NPI Number | 1306144969
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Entity Type | Organization
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Legal Business Name | A NEW INSPIRATION
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 5015 WILLIAMSON RD STE A
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City | ROANOKE
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State | VA
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Zip | 24012-1726
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Country | US
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Telephone | 336-722-2130
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N MAIN ST STE 2222
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City | WINSTON SALEM
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State | NC
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Zip | 27101-3836
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Country | US
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Telephone | 336-722-2130
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MITCHELL BROWN
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Credential |
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Telephone | 336-722-2130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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