Organization
INSPIRE COMMUNITY HOMES LLC
Active
Parent organization
AZZ KICKING MACHINE LLC
Other names
Inspire Community Homes LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AZZ KICKING MACHINE LLC
Authorized official
MR. DEMINGO COLLINS (PRESIDENT / CHIEF EXECUTIVE OFFICER)
(618) 954-6615
Entity
Organization
Contact information
Practice address
4007 MEMORIAL DR, BELLEVILLE, IL 62226-5338
(702) 875-1766
Mailing address
613 LAURELWOOD CT, O FALLON, IL 62269-7064
(618) 954-6615
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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