Provider Demographics
NPI:1003356064
Name:INSPIRATION FOR ASPIRATIONS
Entity Type:Organization
Organization Name:INSPIRATION FOR ASPIRATIONS
Other - Org Name:IFA HOMECARE/NURSING DIVISION
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-664-5363
Mailing Address - Street 1:322 E STATESVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-2594
Mailing Address - Country:US
Mailing Address - Phone:704-664-5363
Mailing Address - Fax:866-929-5355
Practice Address - Street 1:322 E STATESVILLE AVE
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2594
Practice Address - Country:US
Practice Address - Phone:704-664-5363
Practice Address - Fax:866-929-5355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 253Z00000X
NCHC4822251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418834Medicaid