Provider Demographics
NPI:1902397227
Name:INSPIRED BY YOU, LLC
Entity Type:Organization
Organization Name:INSPIRED BY YOU, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MARET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-818-1288
Mailing Address - Street 1:303 S AERIE CT
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-6870
Mailing Address - Country:US
Mailing Address - Phone:208-818-1288
Mailing Address - Fax:
Practice Address - Street 1:411 N 15TH ST
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5476
Practice Address - Country:US
Practice Address - Phone:208-818-1288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDDDA-5372261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities