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NPI Code Detail

MEDICARE: INSPIRATION BEHAVIORAL MANAGEMENT, INC.

MEDICARE: INSPIRATION BEHAVIORAL MANAGEMENT, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency2531-CNV

Other Identifiers

General Provider Information

NPI Number : 1306094578
Entity Type Code : Organization
Provider Name (Legal Business Name) : INSPIRATION BEHAVIORAL MANAGEMENT, INC.
Provider Business Mailing Address
First Line : 3900 W CHARLESTON BLVD STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1682
Country : US
Telephone Number : 702-453-4673
Fax Number : 702-453-2673
Provider Business Practice Location Address
First Line : 3900 W CHARLESTON BLVD STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1682
Country : US
Telephone Number : 702-453-4673
Fax Number : 702-453-2673
Authorized Official
Title or Position : CEO
Name : MRS. PRISCILLA V OTOO-DAVIS
Credential : M.S.W.
Telephone Number : 702-453-4673
Provider Enumeration Date : 08/29/2008
Last Update Date : 02/01/2011

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Directions to “INSPIRATION BEHAVIORAL MANAGEMENT, INC. ” Practice Location

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