Provider Demographics
NPI:1053635490
Name:INSPIRATION FOR ASPIRATIONS
Entity Type:Organization
Organization Name:INSPIRATION FOR ASPIRATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MARANVILLE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:QP/BS
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:186-692-9535
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:186-692-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251C00000X
NC251J00000X, 251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418834Medicaid