Provider Demographics
NPI:1689036584
Name:INSPIRING RADIANCE, LLC
Entity Type:Organization
Organization Name:INSPIRING RADIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:772-266-3064
Mailing Address - Street 1:901 SW MARTIN DOWNS BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2861
Mailing Address - Country:US
Mailing Address - Phone:772-266-3064
Mailing Address - Fax:
Practice Address - Street 1:901 SW MARTIN DOWNS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2861
Practice Address - Country:US
Practice Address - Phone:772-266-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1548670060Medicaid