Provider Demographics
NPI:1184343287
Name:INSPIRATION OF THE VALLEY LLC
Entity type:Organization
Organization Name:INSPIRATION OF THE VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HCBS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-696-6109
Mailing Address - Street 1:2432 W PEORIA AVE STE 1160
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4734
Mailing Address - Country:US
Mailing Address - Phone:623-696-0376
Mailing Address - Fax:
Practice Address - Street 1:2432 W PEORIA AVE STE 1160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4734
Practice Address - Country:US
Practice Address - Phone:623-696-0376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ330824Medicaid