Provider Demographics
NPI:1043784317
Name:INSPIRE YOUTHS, LLC
Entity Type:Organization
Organization Name:INSPIRE YOUTHS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS-BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-801-4946
Mailing Address - Street 1:206 LAKEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3610
Mailing Address - Country:US
Mailing Address - Phone:561-801-4946
Mailing Address - Fax:
Practice Address - Street 1:206 LAKEN DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BCH
Practice Address - State:FL
Practice Address - Zip Code:33409-3610
Practice Address - Country:US
Practice Address - Phone:561-801-4946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health