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General NPI Number Information
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NPI Number | 1679056857
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Entity Type | Organization
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Legal Business Name | INSPIRE TO RISE, INC.
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 09/04/2021
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Provider Practice Location Address
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Address Line | 5927 OLD TIMUQUANA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210
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Country | US
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Telephone | 844-937-4731
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Fax | 904-490-8394
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Provider Business Mailing Address
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Address Line | 5927 OLD TIMUQUANA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-7889
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Country | US
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Telephone | 844-937-4731
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. AIDA PANTALEON SEERAJ
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Credential |
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Telephone | 844-937-4731
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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