Provider Demographics
NPI:1700476744
Name:INSPIRE TO SERVE
Entity Type:Organization
Organization Name:INSPIRE TO SERVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANGELINA BAILEY
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN,CMSRN
Authorized Official - Phone:718-213-5641
Mailing Address - Street 1:1079 DIXIE BELLE CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-3490
Mailing Address - Country:US
Mailing Address - Phone:718-213-5641
Mailing Address - Fax:
Practice Address - Street 1:1079 DIXIE BELLE CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-3490
Practice Address - Country:US
Practice Address - Phone:718-213-5641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care