Provider Demographics
NPI:1710551262
Name:INSPIRATIONAL COMMUNITY HEALTH CENTER LLC
Entity type:Organization
Organization Name:INSPIRATIONAL COMMUNITY HEALTH CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOVIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:336-646-2000
Mailing Address - Street 1:801 SUMMIT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7813
Mailing Address - Country:US
Mailing Address - Phone:336-646-2000
Mailing Address - Fax:
Practice Address - Street 1:801 SUMMIT AVE STE 1
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7813
Practice Address - Country:US
Practice Address - Phone:336-646-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty