# INSPIRE YOUTH ACADEMY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598161788
- **Authorized official:** MR. CHRISTOPHER WALSH (MEMBER)
- **Authorized official phone:** (813) 644-7753

## Contact information

- **Practice address:** 757 SE 17TH ST, \#328, FT LAUDERDALE, FL 33316-2960
- **Practice address phone:** (813) 644-7753
- **Practice address fax:** (888) 482-2405
- **Mailing address:** 24 SW 10TH ST, UNIT A, FT LAUDERDALE, FL 33315-1272
- **Mailing address phone:** (813) 644-7753
- **Mailing address fax:** (888) 482-2405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/14/2014
- **Last updated:** 11/14/2014