Provider Demographics
NPI:1699153213
Name:INSPIRED INCORPORATED
Entity type:Organization
Organization Name:INSPIRED INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-207-3479
Mailing Address - Street 1:8704 STATE ST
Mailing Address - Street 2:
Mailing Address - City:EAST SAINT LOUIS
Mailing Address - State:IL
Mailing Address - Zip Code:62203-2048
Mailing Address - Country:US
Mailing Address - Phone:618-207-3479
Mailing Address - Fax:618-216-1172
Practice Address - Street 1:8704 STATE ST
Practice Address - Street 2:
Practice Address - City:EAST SAINT LOUIS
Practice Address - State:IL
Practice Address - Zip Code:62203-2048
Practice Address - Country:US
Practice Address - Phone:618-207-3479
Practice Address - Fax:618-216-1172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA4215-0001-A251B00000X, 251S00000X, 252Y00000X
251K00000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children