Provider Demographics
NPI:1528292067
Name:INSPIRATIONS EARLY INTERVENTION, INC.
Entity type:Organization
Organization Name:INSPIRATIONS EARLY INTERVENTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRIMM LUCERO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:505-550-2643
Mailing Address - Street 1:7010 PHOENIX AVE NE
Mailing Address - Street 2:SUITE 709
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3548
Mailing Address - Country:US
Mailing Address - Phone:505-550-2643
Mailing Address - Fax:
Practice Address - Street 1:7010 PHOENIX AVE NE
Practice Address - Street 2:SUITE 709
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3548
Practice Address - Country:US
Practice Address - Phone:505-550-2643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM235OtherPHYSICAL THERAPIST LICENSE