Provider Demographics
NPI:1720484868
Name:INSPIRED BEHAVIORAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:INSPIRED BEHAVIORAL SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:CASSARETTO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:209-549-6370
Mailing Address - Street 1:16925 SCHELL RD
Mailing Address - Street 2:
Mailing Address - City:KNIGHTS FERRY
Mailing Address - State:CA
Mailing Address - Zip Code:95361-8705
Mailing Address - Country:US
Mailing Address - Phone:209-549-6370
Mailing Address - Fax:209-881-3414
Practice Address - Street 1:340 MISSION RIDGE DR
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-6884
Practice Address - Country:US
Practice Address - Phone:209-549-6370
Practice Address - Fax:209-881-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1A-50-21252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency