Provider Demographics
NPI:1497106835
Name:INSPIRE SUCCESS ONE CORPORATION
Entity Type:Organization
Organization Name:INSPIRE SUCCESS ONE CORPORATION
Other - Org Name:PATRICIA GREEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-362-2687
Mailing Address - Street 1:927 S GOLDWYN AVE
Mailing Address - Street 2:SUITE #218
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-4324
Mailing Address - Country:US
Mailing Address - Phone:321-362-2687
Mailing Address - Fax:
Practice Address - Street 1:927 S GOLDWYN AVE
Practice Address - Street 2:SUITE #218
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-4324
Practice Address - Country:US
Practice Address - Phone:321-362-2687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management