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General NPI Number Information
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NPI Number | 1396247755
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Entity Type | Organization
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Legal Business Name | INSPIRATION SERVICES FOR CHILDREN & FAMILIES LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 1101 TYVOLA RD OFC 320
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City | CHARLOTTE
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State | NC
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Zip | 28217-3515
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Country | US
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Telephone | 980-292-1855
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Fax |
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Provider Business Mailing Address
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Address Line | 8331 RIVERBIRCH DR APT 304
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City | CHARLOTTE
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State | NC
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Zip | 28210-5994
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Country | US
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Telephone | 917-518-8404
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | ADENIA PEREZ LOPEZ
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Credential | LCSWA
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Telephone | 980-292-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | P011890
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | P011890
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License Number State | NC
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