Provider Demographics
NPI:1164126264
Name:INSPIRED HEALTHCARE STAFFING LLC
Entity Type:Organization
Organization Name:INSPIRED HEALTHCARE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-441-9489
Mailing Address - Street 1:59 TYLERTOWN MESA RD
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-6064
Mailing Address - Country:US
Mailing Address - Phone:601-441-9489
Mailing Address - Fax:
Practice Address - Street 1:612 DELAWARE AVE STE 30
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-4000
Practice Address - Country:US
Practice Address - Phone:601-441-9489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care