Provider Demographics
NPI:1205451689
Name:INSPIRE OF PALM BEACH
Entity type:Organization
Organization Name:INSPIRE OF PALM BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:B
Authorized Official - Last Name:COLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:561-377-8772
Mailing Address - Street 1:1803 S AUSTRALIAN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6454
Mailing Address - Country:US
Mailing Address - Phone:561-377-8772
Mailing Address - Fax:
Practice Address - Street 1:1803 S AUSTRALIAN AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6454
Practice Address - Country:US
Practice Address - Phone:561-377-8772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder