Provider Demographics
NPI:1821564626
Name:INSPIRING CREATIVE LIVING LLC
Entity Type:Organization
Organization Name:INSPIRING CREATIVE LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGEMNT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL MANAGEMENT
Authorized Official - Phone:901-604-3475
Mailing Address - Street 1:3295 BOONE ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-6664
Mailing Address - Country:US
Mailing Address - Phone:901-405-5822
Mailing Address - Fax:
Practice Address - Street 1:3295 BOONE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-6664
Practice Address - Country:US
Practice Address - Phone:901-405-5822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty