Provider Demographics
NPI:1265005714
Name:HOUSE OF INSPIRATION RESIDENTIAL SERVICES LLC
Entity Type:Organization
Organization Name:HOUSE OF INSPIRATION RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-723-3688
Mailing Address - Street 1:1303 DIXON CIR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-4063
Mailing Address - Country:US
Mailing Address - Phone:214-723-3688
Mailing Address - Fax:
Practice Address - Street 1:1303 DIXON CIR
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-4063
Practice Address - Country:US
Practice Address - Phone:214-723-3688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health