Provider Demographics
NPI:1619044682
Name:DEDICATED FAMILY INSPIRATIONS, LLC
Entity Type:Organization
Organization Name:DEDICATED FAMILY INSPIRATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCARN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-904-3261
Mailing Address - Street 1:1820 SILVER CITY ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-8604
Mailing Address - Country:US
Mailing Address - Phone:910-904-0736
Mailing Address - Fax:910-875-1080
Practice Address - Street 1:1820 SILVER CITY ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-8604
Practice Address - Country:US
Practice Address - Phone:910-904-0736
Practice Address - Fax:910-875-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC047-078320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603793Medicaid