Provider Demographics
NPI:1104346881
Name:INSPIRATION FOR US
Entity type:Organization
Organization Name:INSPIRATION FOR US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO /DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:BSQP
Authorized Official - Phone:336-934-9334
Mailing Address - Street 1:1205 W MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2173
Mailing Address - Country:US
Mailing Address - Phone:336-934-9334
Mailing Address - Fax:
Practice Address - Street 1:1205 W MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2173
Practice Address - Country:US
Practice Address - Phone:336-934-9334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children