Provider Demographics
NPI:1306144969
Name:A NEW INSPIRATION
Entity type:Organization
Organization Name:A NEW INSPIRATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-722-2130
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:STE 2222
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3836
Mailing Address - Country:US
Mailing Address - Phone:336-722-2130
Mailing Address - Fax:
Practice Address - Street 1:5015 WILLIAMSON RD
Practice Address - Street 2:STE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-1726
Practice Address - Country:US
Practice Address - Phone:336-722-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health