MEDICARE: INSPIRE TO BE DIFFERENT

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
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1639992779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRE TO BE DIFFERENT

Provider Business Mailing Address
First Line	:	1930 FREEMAN ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-4310
Country	:	US
Telephone Number	:	419-503-6703
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 FREEMAN ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-4310
Country	:	US
Telephone Number	:	419-503-6703
Fax Number	:

Authorized Official
Title or Position	:	INDEPENDENT PROVIDER
Name	:	DANIELLE YOWPP
Credential	:
Telephone Number	:	419-503-6703

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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Directions to “INSPIRE TO BE DIFFERENT ” Practice Location

Language	Start Address	Practice Location

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