Provider Demographics
NPI:1326431057
Name:INSPIRE THE YOUTH LLC
Entity Type:Organization
Organization Name:INSPIRE THE YOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:JUNIOR
Authorized Official - Last Name:OSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-277-3554
Mailing Address - Street 1:PO BOX 5417
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-0090
Mailing Address - Country:US
Mailing Address - Phone:973-277-3554
Mailing Address - Fax:215-358-8466
Practice Address - Street 1:436 HOWE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-1934
Practice Address - Country:US
Practice Address - Phone:973-277-3554
Practice Address - Fax:215-358-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health