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Organization

INSPIRATIONS GROUP HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK HALLBACK (MANAGING DIRECTOR / OWNER)
(602) 794-7695
Entity
Organization

Contact information

Practice address
7113 S 7TH LN, PHOENIX, AZ 85041-6766
(602) 323-2601
(602) 476-6980
Mailing address
7113 S 7TH LN, PHOENIX, AZ 85041-6766
(602) 323-2601
(602) 476-6980

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
445542
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
445542
STATE OF ARIZONA DIVISION OF DEVELOPMENTAL DISABILITIES / AHCCCS
AZ
Enumeration date
11/04/2009
Last updated
12/29/2011
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