Provider Demographics
NPI:1720732670
Name:INSPIRE ADVOCACY SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:INSPIRE ADVOCACY SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATREENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-978-5554
Mailing Address - Street 1:16017 JOHNS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-9013
Mailing Address - Country:US
Mailing Address - Phone:352-978-5554
Mailing Address - Fax:352-702-6382
Practice Address - Street 1:16017 JOHNS LAKE RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-9013
Practice Address - Country:US
Practice Address - Phone:352-978-5554
Practice Address - Fax:352-702-6382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities