Provider Demographics
NPI:1457005779
Name:INSPIRED COMMUNITY PROJECT INC
Entity Type:Organization
Organization Name:INSPIRED COMMUNITY PROJECT INC
Other - Org Name:THE INSPIRED COMMUNITY PROJECT, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, NY-LBA
Authorized Official - Phone:646-345-6954
Mailing Address - Street 1:1864 7TH AVE APT 44
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2842
Mailing Address - Country:US
Mailing Address - Phone:646-345-6954
Mailing Address - Fax:
Practice Address - Street 1:1864 7TH AVE APT 44
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2842
Practice Address - Country:US
Practice Address - Phone:646-345-6954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-06
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty