Provider Demographics
NPI:1407116866
Name:INSPIRED HOPE MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:INSPIRED HOPE MENTAL HEALTH SERVICES, LLC
Other - Org Name:INSPIRED HOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-203-6524
Mailing Address - Street 1:4005 PEPPER THORN AVE
Mailing Address - Street 2:201
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-3818
Mailing Address - Country:US
Mailing Address - Phone:702-203-6524
Mailing Address - Fax:
Practice Address - Street 1:4005 PEPPER THORN AVE
Practice Address - Street 2:201
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-3818
Practice Address - Country:US
Practice Address - Phone:702-203-6524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-19
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty