Provider Demographics
NPI:1134816143
Name:INSPIRATIONAL THERAPY L.L.C.
Entity type:Organization
Organization Name:INSPIRATIONAL THERAPY L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST MENTAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JEFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-699-5673
Mailing Address - Street 1:1201 LINCOLN WAY APT 107
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2384
Mailing Address - Country:US
Mailing Address - Phone:208-699-5673
Mailing Address - Fax:
Practice Address - Street 1:55 N CEDAR ST STE 110
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6220
Practice Address - Country:US
Practice Address - Phone:208-699-5673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)