Provider Demographics
NPI:1811474299
Name:TIME 2 INSPIRE, LLC
Entity type:Organization
Organization Name:TIME 2 INSPIRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:BSW/CRC
Authorized Official - Phone:770-371-4017
Mailing Address - Street 1:3675 CRESTWOOD PKWY NW STE 400
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5054
Mailing Address - Country:US
Mailing Address - Phone:770-371-4017
Mailing Address - Fax:
Practice Address - Street 1:4554 ANNISTOWN RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-7308
Practice Address - Country:US
Practice Address - Phone:770-371-4017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251C00000X, 385HR2050X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp