Provider Demographics
NPI:1902680218
Name:INSPIRATION STATION
Entity Type:Organization
Organization Name:INSPIRATION STATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUL-RAHMAAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:310-307-6838
Mailing Address - Street 1:312 S 4TH ST FL 7
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3030
Mailing Address - Country:US
Mailing Address - Phone:502-214-3539
Mailing Address - Fax:
Practice Address - Street 1:312 S 4TH ST FL 7
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3030
Practice Address - Country:US
Practice Address - Phone:502-214-3539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty