Provider Demographics
NPI:1891029062
Name:A NEW INSPIRATION
Entity Type:Organization
Organization Name:A NEW INSPIRATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:KENDELL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-776-7631
Mailing Address - Street 1:6 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2720
Mailing Address - Country:US
Mailing Address - Phone:336-776-7631
Mailing Address - Fax:336-722-4499
Practice Address - Street 1:6 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2720
Practice Address - Country:US
Practice Address - Phone:336-776-7631
Practice Address - Fax:336-722-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health