Provider Demographics
NPI:1619672102
Name:INSPIRATION BEHAVIOR HEALTH CLINIC
Entity Type:Organization
Organization Name:INSPIRATION BEHAVIOR HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:DZAMESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-717-1729
Mailing Address - Street 1:3210 W CHARLESTON BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0080
Mailing Address - Country:US
Mailing Address - Phone:661-717-1729
Mailing Address - Fax:
Practice Address - Street 1:3210 W CHARLESTON BLVD STE 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0080
Practice Address - Country:US
Practice Address - Phone:661-717-1729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty