Provider Demographics
NPI:1538955307
Name:KINSPIRE WELLNESS GROUP LLC
Entity type:Organization
Organization Name:KINSPIRE WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNCIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-997-5596
Mailing Address - Street 1:5217 FOX HUNT DR APT G
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-6355
Mailing Address - Country:US
Mailing Address - Phone:203-997-5596
Mailing Address - Fax:
Practice Address - Street 1:5217 FOX HUNT DR APT G
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-6355
Practice Address - Country:US
Practice Address - Phone:203-997-5596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities