Provider Demographics
NPI:1679047534
Name:INSPIRE ME, LLC
Entity Type:Organization
Organization Name:INSPIRE ME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRINCIPAL
Authorized Official - Prefix:MS
Authorized Official - First Name:SWEETS
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-869-8067
Mailing Address - Street 1:1-2 CAMELOT DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002
Mailing Address - Country:US
Mailing Address - Phone:860-869-8067
Mailing Address - Fax:860-242-5319
Practice Address - Street 1:1-2 CAMELOT DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002
Practice Address - Country:US
Practice Address - Phone:860-869-8067
Practice Address - Fax:860-242-5319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSPIRE ME, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008064106Medicaid